DRUG NAME MODE OF ACTION INDICATIONS CONTRAINDICATION SIDE EFFECTS/ NURSING

S ADVERSE EFFECTS INTERVENTIONS

Generic Name: Competes with Oncology-related: Hypersensitivity to CNS:  Observe the 10
Methotrexate enzymes necessary Treatment of methotrexate. Aphasia, cerebral Rights of
to reduce folic acid breast, Breastfeeding. thrombosis, chills, Medication
Brand Name: to tetrahydrofolic head/neck, non– dizziness, drowsiness,  If patient
Rheumatrex, Trexall, acid, a component small-cell lung, Additional: fatigue, fever, receives high
Otrexup, Rasuvo essential to DNA small-cell lung  For patients with headache, doses of drug,
synthesis, repair, carcinomas; psoriasis, juvenile hemiparesis, keep leucovorin
Therapeutic Class: and cellular trophoblastic idiopathic arthritis or leukoencephalopathy, readily available
Antineoplastics, replication. tumors, acute rheumatoid arthritis: malaise, paresis, as antidote
antirheumatics lymphocytic, Pregnancy, hepatic seizures  Monitor vital
(DMARDs), THERAPEUTIC meningeal disease, alcoholism, CV: signs periodically
immunosuppressants OUTCOME: leukemias;non- immunodeficiency Chest pain, deep vein during
Inhibits DNA, Hodgkin’s syndrome, thrombosis, administration.
Pharmacological protein synthesis. lymphomas preexisting blood hypotension, And Monitor
class: Possesses anti- (lymphosarcoma, dyscrasias. pericardial effusion, intake and
Antimetabolites, Folic inflammatory and Burkitt’s pericarditis, output ratios and
acid antagonist immune-modulating lymphoma), Cautions: thromboembolism daily weights.
activity. carcinoma of  Peptic ulcer, ENDO:  Assess
Actual dose, Timing Prevention of  gastrointestinal ulcerative colitis, Gynecomastia nutritional status.
and Route: rapidly growing tract, mycosis preexisting EENT: Administering an
malignant cells; fungoides, myelosuppression, Blurred vision, antiemetic prior
Acute lymphocytic immunosuppressio osteosarcoma. conjunctivitis,
history of chronic to and
leukemia n Non-oncology gingivitis, glossitis,
hepatic disease, periodically
Adult and child: uses: pharyngitis, stomatitis,
alcohol consumption, during therapy
PO/IM/IV 3.3 mg/m2 transient blindness,
 Psoriasis, obesity, diabetes, and adjusting
/day x 4-6 wk until tinnitus
rheumatoid hyperlipidemia, use diet as tolerated
remission, then 20-
arthritis (including with other may help
30 mg/m2 PO/ GI:
juvenile hepatotoxic maintain fluid
IM qwk in 2 divided Abdominal pain,
idiopathic medications, and electrolyte
doses or 2.5 mg/kg anorexia, cirrhosis,
arthritis) concomitant use of balance and
IV x 2 wk diarrhea, elevated liver
Off-label: proton pump nutritional status.
Burkitt’s lymphoma  Treatment of inhibitors. function test results, Report
(stages I, II, III) acute myelocytic  Use of NSAIDs or enteritis, GI bleeding significant
(unlabeled) leukemia, aspirin with lower and ulceration, changes
Adult: PO 10-25 bladder methotrexate doses hepatitis,  Assess and
mg/day x 4-8 days carcinoma, for rheumatoid hepatotoxicity, monitor
with 7-day rest ectopic arthritis. nausea, symptoms
period pregnancy, pancreatitis, vomiting indicating severe
management of GU: allergic reaction;
Lymphosarcoma abortion, Cystitis, hematuria, therapy may
(stage III) systemic lupus infertility, menstrual need to be
Adult: PO/IM/IV erythematosus, dysfunction, discontinued
0.625-2.5 mg/kg/day treatment of and nephropathy, renal  Teach patient to
maintenance of failure, tubular avoid use of
Meningeal leukemia remission in necrosis, vaginal products
Adult and child: 12 Crohn’s disease. discharge containing
mg/m2 IT q2-5days HEME: aspirin or
until CSF is normal, Anemia, aplastic NSAIDs, razors,
then one additional anemia, leukopenia, commercial
dose, max neutropenia, mouthwash,
15 mg pancytopenia, since bleeding
thrombocytopenia may occur; to
MS: report symptoms
Choriocarcinoma Arthralgia, dysarthria, of bleeding,
Adult and child: myalgia, stress changes in
PO/IM 15-30 fracture breathing or
mg/kg/day x 5 RESP: coughing, CNS
days, then off 1 wk; Dry nonproductive symptoms,
may repeat cough, dyspnea, vision changes,
Interstitial signs of anemia,
Breast cancer pneumonitis, symptoms of
Adult: IV 40-60 pneumonia, infection
mg/m2 on day 1 of pulmonary fibrosis or
every 21-28 days failure, pulmonary
with other
antineoplastics infiltrates
INTEG:
Epidermal Acne, alopecia,
head/neck cancer altered skin
Adult/child: IV 40 pigmentation,
mg/m2 on days 1 ecchymosis, erythema
and 15, q21 days multiforme, exfoliative
alone or in dermatitis,
combination with furunculosis, necrosis,
bleomycin, photosensitivity,
CISplatin pruritus, psoriatic
Adult: PO 25-50 lesions, rash, Stevens-
mg/m2 q7 days Johnson syndrome,
Child: PO 7.5-30 telangiectasia, toxic
mg/m2 q7-14 days epidermal necrolysis,
ulceration, urticaria
Other:
Anaphylaxis,
Rheumatoid increased risk of
arthritis infection,
Adult: PO 7.5 lymphadenopathy,
mg/wk or divided lymphoproliferative
doses of 2.5 mg disease
q12hr x 3 given
qwk, max 20 mg/wk

Polyarticular-
course juvenile RA
Child: PO/IM 10
mg/m2 qwk

Osteosarcoma
Adult and child: IV
12 g/m2 given over
4 hr,
then leucovorin
rescue is given

Mycosis fungoides
Adult: PO 2.5-10
mg/day until
cleared (may be
many mo); IM 50
mg qwk or 15-37.5
mg 2x/wk

Psoriasis
Adult: PO/IM/IV 10-
25 mg qwk or 2.5
mg PO q12hr x 3
doses qwk; may
increase to 25 mg
qwk

Available forms:
Tabs 2.5, 5, 
7.5, 10, 15 mg;
inj 25 mg/ml;
powder for inj 1 g