Methotrexate sodium

Folate deficiency Folate deficiency states may increase methotrexate toxicity. Benzyl alcohol Methotrexate sodium for injection contains the preservative benzyl alcohol and is not recommended for use in neonates. 

Folic acid analogs methotrexate sodium raltitrexed disodium... 

Methotrexate, sodium (15475-56-6) Methylmercuric chloride (00115-09-3) Methylroercury chloride (00115-09-3) Methylmercury dicyandiamide (00502-39-6) Methylmercury hydroxide (01184-57-2)... 

The mixture of methotrexate sodium with cytarabine, fluorouracil, hydrocortisone sodium, and prednisolone sodium phosphate produces precipitate upon storage, although it is not observed immediately. A concentration-dependent photodegradation was reported for methotrexate and considered high in the presence of bicarbonate ions and unprotected polybutadiene tubings.226 Methotrexate wastes may be disposed of by oxidation with potassium permanganate and sulfuric acid or by oxidation with aqueous alkaline hypochlorite. 

Proprietary Names of Methotrexate and Methotrexate Sodium. Emtexate Ledertrexate Mexate. 

Methotrexate sodium. Wyeth Fhaimaceuticals. UK Summary of product characteristics, September 2006. 

Kozloski GD, De Vito JM, Kisicki JC, Johnson JB. The effect of food on the absorption of methotrexate sodium tablets in healthy volunteers. Arthritis Rheum (1992) 35, 761—4. 

Methohexital sodium Diethyl-p-methylaminobenzoyl-L-glutamate Methotrexate... 

Oral administration of bicarbonate may decrease the absorption of ketoconazole. Increased blood levels of quinidine, flecainide, or sympatiiomimetics may occur when these agents are administered with bicarbonate There is an increased risk of crystalluria when bicarbonate is administered with the fluoroquinolones. Fbssible decreased effects of lithium, methotrexate, chlorpropamide, salicylates, and tetracyclines may occur when these drag s are administered with sodium bicarbonate. Sodium bicarbonate is not administered within 2 hours of enteric-coated drugs the protective enteric coating may disintegrate before the drug reaches the intestine. 

RH is admitted to the pediatric oncology service. She is started on allopurinol and intravenous fluids with sodium bicarbonate to prevent tumor lysis syndrome. According to her risk status, she will receive a three-drug induction with vincristine, dexamethasone, and pegylated asparaginase. She also will receive intrathecal (IT) chemotherapy for CNS prophylaxis with methotrexate, cytarabine, and hydrocortisone. 

There have been several studies that underscore the importance of unbound concentration in cell-based studies of receptor function. In a model study of the effect of plasma protein binding on the renal transport of organic anions using the expression of various organic anion transporters (OATPs) in Xenopus oocytes, the transport of ochratoxin A, methotrexate, and estrone sulfate was found to be strongly inhibited by the addition of human serum albumin to the culture medium [16]. Similarly, the addition of oq-acid glycoprotein was found to reverse the blockade of sodium-ion current by cocaine in a preparation of cardiac myocytes [17]. 

The first-line agents in the treatment of rheumatoid arthritis are non-steroidal anti-inflammatory drugs such as diclofenac. Diclofenac and indometacin, another NSAID, tend to have similar activity hov/ever, indometacin has a higher incidence of side-effects and therefore diclofenac is more appropriate for initial treatment. Sodium aurothiomalate is classified as a disease-modifying antirheumatic drug and is used as a second-line treatment in rheumatoid arthritis, but has been superseded by methotrexate, administered v/eekly. Paracetamol is often indicated in the management of osteoarthritis. Local intra-articular injections of dexamethasone may be administered for the relief of soft-tissue inflammatory conditions. 

Urine alkalinization is a treatment modality that increases elimination of poisons by the intravenous administration of sodium bicarbonate to produce urine with a pH of more than or equal to 7.5 and must be supported by high urine flow. This technique might be useful for the elimination of drugs with an acid pKa such as salicylates (but not recommended for phenobarbital intoxication for which multiple-dose activated charcoal is better), chlorpropamide, 2,4-dichlorophenoyacetic acid, diflunisal, fluoride, mecoprop, methotrexate. Complications include severe alkalemia, hypokalemia, hypocalcemia and coronary vasoconstriction. 

Patients who take methotrexate (3.45) (Figure 3.22) must monitor the pH of their urine several times a day. If the pH rises above 7, the patient must receive a dose of sodium bicarbonate (a weak base) either orally or as an IV solution. Why is the pH of the urine important ... 

Wear goggles, rubber gloves, and protective clothing. Work in the fume hood. Add the methotrexate (80 mg) to 100 mL of household bleach (5% sodium hypochlorite) in a 200-mL beaker. Allow to stand at room temperature for 30 minutes. Wash the liquid into the drain with water. Immerse vials and glassware that contain residues of methotrexate in bleach for at least 30 minutes, and then rinse thoroughly with water and discard.4,5... 

Droperidol Droperidol has pH-dependent incompatibility with many drugs. It is not compatible with nafcillin sodium, fluorouracil, folic acid, frusemide, heparin, methotrexate, or barbiturates. Droperidol should not be stored in PVC bags containing intravenous infusions, although some solutions appear to be stable.157... 

Bleomycin Bleomycin is incompatible and loses its potency if it is administered with solutions of benzylpenicillin sodium, carbenicillin, cephazolin or cephalothin sodium, hydrocortisone sodium succinate, mitomycin, methotrexate, nafcillin sodium, aminophylline, ascorbic acid, terbutaline, divalent and trivalent cations (especially copper), compounds containing sulfhydryl groups, and precipitation by hydrophobic anions, essential amino acids, riboflavine, dexamethasone, and frusemide. 

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