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  • Problematika visokih odmerkov metotreksata pri onkoloških bolnikih = Problems of high-dose methotrexate in oncological patients
    Tavčar, Petra, farmacija ; Sonc, Monika ; Kmetec, Vojko
    Background: High-dose methotrexate is the only agent used in cancer therapy that requires routine measurements of serum concentrations to avoid potentially fatal high doses of methotrexate. The drug ... is used to treat osteosarcomas and non-Hodgkinćs lymphomas. As serum levels of methotrexate in patients treated at the Institute of Oncology were often elevated, we undertook this study to identify the parameters that increase serum methotrexate levels. Patients and Methods: All patients receiving a one-year course of high-dose methotrexate (n=20) were included in the study, regardlessof whether they had elevated or normal serum concentrations of methotrexate. Altogether, they received 55 high-dose methotrexate therapies. The following parameters likely to affect serum concentrations of methotrexatewere investigated: drug manufacturer, the person preparing the infusion, body mass index, patientćs age, creatinine clearance, estimated creatinine clearance, urine pH, concomitant chemotherapy with procarbazine, concomitant therapy with omeprazole, aspirin and nonsteroidal antirheumatic drugs. Interactions were statistically evaluated using the c2-test. Results: In 28 of the 55 therapies there was at least one case of elevated methotrexateconcentrations. Serum methotrexate concentrations in patients withlymphomas were significantly increased in elderly patients, in patients with high body mass index, those with creatinine clearance of < 100ml/min, andin patients on procarbazine or omeprazole therapy. Conclusions: In order toavoid adverse side-effects of high-dose chemotherapy, the dosage of methotrexate should be carefully adjusted in accord to important factors that may increase its concentration, and possible interactions with other drugs should be prevented.
    Vir: Zdravstveno varstvo : Slovenian journal of public health. - ISSN 0351-0026 (Letn. 49, št. 4, 2010, str. 160-169)
    Vrsta gradiva - članek, sestavni del
    Leto - 2010
    Jezik - slovenski
    COBISS.SI-ID - 2899825

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    Digitalna knjižnica Slovenije - dLib.si

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