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Paper II — 2017 August (Supplementary) (2010 Scheme) — Q12

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Paper II
2017 August (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Rationale for the use of folinic acid in methotrexate overdose

Q121 marksShort Answers

Answer

Methotrexate inhibits dihydrofolate reductase, blocking regeneration of tetrahydrofolate needed for nucleotide/DNA synthesis, which affects both malignant and normal rapidly dividing cells (causing myelosuppression, mucositis). Folinic acid (leucovorin) bypasses the blocked enzymatic step by directly providing the active tetrahydrofolate derivative, “rescuing” normal cells from toxicity in overdose/high-dose therapy — this is the basis of “leucovorin rescue.”

  1. 1Cancer Chemotherapy

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