What should be monitored as a methotrexate consideration?

What should be monitored as a methotrexate consideration?

• A. Decreased risk of infection
• B. Increased hair growth
• C. No special considerations
• D. Increased risk of infection

Answer: (D)

Methotrexate can suppress the immune system, so infection risk is the key thing to monitor. It blocks folate metabolism, which reduces DNA synthesis in rapidly dividing cells, including bone marrow cells that produce white blood cells. That can lead to lowered white blood cell counts (leukopenia and neutropenia), making it harder for the body to fight infections. Because of this, regular checks of blood counts are essential, along with liver and kidney function tests to assess how well the drug is tolerated and cleared. Clinically, watch for signs of infection such as fever, chills, cough, sore throat, or mouth ulcers, and instruct patients to report fever promptly. In addition, while hair growth isn’t a benefit of methotrexate (it can cause hair thinning or loss), and ignoring special considerations would miss important safety steps. Providing folic acid supplementation can help with some side effects, but the main monitoring focus remains infection risk due to immune suppression.

Methotrexate can suppress the immune system, so infection risk is the key thing to monitor. It blocks folate metabolism, which reduces DNA synthesis in rapidly dividing cells, including bone marrow cells that produce white blood cells. That can lead to lowered white blood cell counts (leukopenia and neutropenia), making it harder for the body to fight infections. Because of this, regular checks of blood counts are essential, along with liver and kidney function tests to assess how well the drug is tolerated and cleared. Clinically, watch for signs of infection such as fever, chills, cough, sore throat, or mouth ulcers, and instruct patients to report fever promptly. In addition, while hair growth isn’t a benefit of methotrexate (it can cause hair thinning or loss), and ignoring special considerations would miss important safety steps. Providing folic acid supplementation can help with some side effects, but the main monitoring focus remains infection risk due to immune suppression.