Therapeutic Drug Monitoring of Methotrexate after its Administration in High-Dose Protocols.
Summary of "Therapeutic Drug Monitoring of Methotrexate after its Administration in High-Dose Protocols."
After HD-MTX infusions, i.e. at a dose > 1 g/m(2), monitoring of serum MTX concentrations is a standard practice which helps reducing the incidence of toxicity in patients with decreased clearance by guiding dose adjustment of leucovorin. Therapeutic monitoring of methotrexate is based on iterative measurements of serum concentration until concentration is below a certain threshold. This practice is supported by numerous observations of exposure-related toxicity as well as some clinical studies comparing drug exposure between patients with and without toxicity. Despite no prospective clinical study has clearly demonstrated the usefulness of methotrexate TDM, historical comparison reveals a huge reduction of toxicity-related events over past decades. Systematic monitoring may also help identifying patients with abnormally high methotrexate concentrations, who require immediate treatment with carboxypeptidase.
Affiliation
Université François Rabelais de Tours ; CHRU de Tours, France.
Journal Details
This article was published in the following journal.
Name: Therapie
ISSN: 0040-5957
Pages: 163-169
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20699066
- DOI: http://dx.doi.org/10.2515/therapie/2010016
Medical and Biotech [MESH] Definitions
Drug Tolerance
Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.
Drug Combinations
Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.
Dose-response Relationship, Drug
The relationship between the dose of an administered drug and the response of the organism to the drug.
Administration, Topical
The application of drug preparations to the surfaces of the body, especially the skin (ADMINISTRATION, CUTANEOUS) or mucous membranes. This method of treatment is used to avoid systemic side effects when high doses are required at a localized area or as an alternative systemic administration route, to avoid hepatic processing for example.
Dose Fractionation
Administration of the total dose of radiation (RADIATION DOSAGE) in parts, at timed intervals.
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