Paper II
2019 February (2010 Scheme)
Question
Methotrexate
Q43 marksShort Notes
Answer
Methotrexate is a folate antagonist (antimetabolite).
Mechanism of action
- Inhibits dihydrofolate reductase, blocking regeneration of tetrahydrofolate needed for purine/thymidylate synthesis (S-phase specific)
Uses
- Malignancies: ALL, choriocarcinoma, osteosarcoma
- Rheumatoid arthritis (low-dose, weekly)
- Psoriasis
- Ectopic pregnancy
Adverse effects
- Myelosuppression
- Mucositis
- Hepatotoxicity, nephrotoxicity
- Teratogenic
- Pulmonary fibrosis (chronic use)
Rescue agent: Folinic acid (leucovorin)
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