The aim of this assignment is to answer questions created about drugs or medicine that interests me. This will include a holistic view on a medicine called methotrexate. The research would be about what methotrexate is, how it is made, the discovery of the drug, what it's used for and how its physical side effect can affect an individual intellectually, emotionally and socially. It will also include how other related drugs affect individuals. I am going to carry out this investigation by using books, internet, journals, articles and many more.
Methotrexate is a medicine which plays a big act on patients with all sorts of diseases such as cancer, psoriasis and many more. Medicine is an area of human knowledge concerned with resorting health. Medicine has specialised branch which deals with particular organs in the human body such as the cardiovascular, endocrine, haematology, oncology, Nephrons and many more of the internal body.
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They contain non-drug chemicals. The most common way of administering medicine is the oral route. They are usually made into a tablet. A tablet is a solid preparation in which each contain a single dose of one or more active ingredient and obtained by compression of uniform. (Class notes)
Other forms of administering medication could also be injections
How is it injected?
How is it prepared?
WHAT IS METHOTREXATE?
According to the medicinenet (2010) website, Methotrexate is a drug which is categorised as an anti-metabolite meaning it is able to block the metabolism of cells; so therefore, it is very effective when treating certain diseases related with abnormally rapid cell growth, diseases associated with active immune system, or inflammatory conditions, such as cancer of the breast, rheumatoid arthritis and psoriasis.
The buzzle article (2009) states that, Methotrexate acts as an inhibitor to the metabolism folic acid. The website states that the Methotrexate drug makes the immune system less active and suppresses the blood cells which cause the inflammation. The medicinenet (2010) (2010) web page claims that recent researches states that Methotrexate can be used to induce miscarriage, for instance patients with ectopic pregnancy. This occurs by killing the rapidly growing cells of the placenta. It also states that although its mechanism of action in rheumatoid arthritis is unknown, it helps in the treatment of the illness as well as causing it because it alters immunity which plays a role of causing it.
The medicinenet (2010) web address explains that Methotrexate is a prescribed drug in forms of powder for injections (25mg/ml) and also tablets for oral use (2.5, 5, 7.5, 10, and 15 mg) and it is stored in a room temperature of15° to 30°C (59° to 86°F) avoiding light.
It also states that the dose Methotrexate is given weekly by injections or orally to the rheumatoid arthritis and the psoriasis patients. The article on the arthritis (2010) website shows that the treatment takes about 12 weeks onwards to reach full achievements.
The chemical formula for Methotrexate is:http://jpdb.nihs.go.jp/jp/gif_eng/Methotrexate.gif
The medicinenet (2010) website states, research has established that taking non-steroidal anti-inflammatory drugs before or during methotrexate treatment could result in serious unpleasant issues, as the n on-steroidal anti-inflammatory drugs increases the blood concentrations of methotrexate and therefore may result in liver toxicity.
WHAT IS THE INGREDIENT OF METHOTREXATE?
HOW WAS METHOTREXATE DISCOVERED?
According to the methotrexate website (2007), methotrexate was discovered around world war two by Steven Farber. He tested the effects of folic acid for several types of cancers at the children's hospital Boston. There were researchers at Lederle Company studying methotrexate, investigating for drugs that resembled folic acid. This research led to the discovery of methotrexate and therefore the use was finally developed in 1948. In 1953, methotrexate received an FDA approval drug and has been used for a variety of medical interventions.
WHAT ARE THE SIDE EFFECTS?
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Methotrexate is useful in many ways but could also have serious effect on patients related to the dose taken. There are long term and short term effect on individuals on the Methotrexate drug. According to the medicinenet (2010) web address, methotrexate has caused serious, fatal side effects and therefore the medication should only be treated on cancer patient or other diseases such as psoriasis or rheumatoid arthritis. It states that the medication has caused birth defects and fatal death so women must avoid getting pregnant during medication. Pregnant women with rheumatoid arthritis and psoriasis must not take methotrexate as it can be toxic to the embryo and could also cause fatal defects and spontaneous abortion. So it has been stated that men and women on the medication should use reliable forms of birth control. The article on the arthritis (2010) website states that the side effects also include frequent reactions, for instance; mouth sores; stomach upset and low white blood counts. It can also cause severe toxicity to the kidney, liver and the bone marrow and therefore patients on a methotrexate medication are required to monitor themselves with a regular blood test. The website also states that being on the medication causes headaches, drowsiness which maybe determines if the dose is lowered. It also causes itching of the body, skin rash, dizziness hair loss and a dry non-productive cough may result in lung toxicity. The buzzle (2009) article states that it has common side effects and they are Increased Risk of Infection, anaemic, diarrhoea, nausea and vomiting. This is when the white blood cells produced by the bone marrow decreases causing an increased risk of infection. Patients on a methotrexate may suffer from sore throat, pain when passing urine, or may feel cold and shivery. Patients may experience anaemia, which is caused by the diffiency of iron in the body. This can result in a low count on the red blood cells. The website also states that researches show that there is a possibility of a patient on Methotrexate medication becoming anaemic as Methotrexate resulting to lethargy and breathlessness. An individual undergoing methotrexate may have risks of getting diarrhoea and it is insisted that patients on Methotrexate should consult doctors if they experience symptoms of diarrhoea. Feeling nausea and vomiting is another type of side effects. The symptoms are seen when the patient is prescribed with a high dosage of the Methotrexate drug. There are also other side effects and they include abdominal distress, undue fatigue, chills, fever, and leukopenia meaning low white blood cell count.
The drugs (2010) website shows that new infections can arise during and after the therapy with Methotrexate due to drug induced immune suppression and therefore patients are at high dosage of the drug. It also states 'Methotrexate should be help prior to and during elective surgery to minimise the risk odd infections complications.' A cording to the website, limited data have shown that the use of low-dose Methotrexate for patients with rheumatoid arthritis is associated with decreased lymphocytes after 8 weeks of therapy. Methotrexate is usually contraindicated in patients with laboratory evidence of immunodeficiency syndromes and therefore immunisation may be ineffective when given this during the Methotrexate medication.
The drugs (2010) website states that being on the Methotrexate also affects the nervous system. This includes blurred visions, subtle cognitive dysfunctions, moodiness, tinnitus or sometimes cranial sensations. Researchers have shown that medication could cause individuals not to speak. The website states that the development of serious neurotoxicity is more likely if Methotrexate is given in higher dosage to individuals who are currently suffering craniospinal irradiation. Significant neurotoxicity could be known as an acute stroke-like encephalopathy. A syndrome of slight personality changes are followed by a progressive dementia, focal seizures, pseudobulbar palsy, spastic quadriparesis, and stupor may begin several months after the initiation of therapy.
The website also shows that the Methotrexate therapy affects the respiratory system. It states that there is a hypersensitivity reaction and a toxic reaction with diffuse alveolar damage. The hypersensitivity reaction is usually categorised by interstitial pnuemonitis, granuloma formation and the development of bronchopneumonia. It also states that some patients may have symptoms of asthma. It indicates that pulmonary function tests in affected patients reflect a restrictive ventilation defect and decreased diffusion capacities. A mild peripheral eosinophilia is often present. Respiratory side effects for instance toxicity can occur at any dosage.
According to the drugs (2010) website, Methotrexate can cause renal side effects such as renal insufficiency which is commonly associated with a high dose of Methotrexate; this occurs by the 7th hydroxide (OH) on the Methotrexate precipitates in the renal tubule. The use of taking other potentially nephrotoxic drugs like non-steroidal anti-inflammatory drugs (NSAIDs) and pre-existing renal insufficiency are also risk factors. Aggressive and adequate hydration urine alkalisation can help to minimise the risk of Methotrexate- induced nephropathy, cystitis, and hematuria but regular monitoring of the revealed renal dysfunction decreasing the Methotrexate doses or stopping the usage of the drug may help to improve renal function.
It also states that the usage of Methotrexate can cause genitourinary side effect which may seriously affect either sex. It explains that women may experience menstrual dysfunction, constant vaginal discharge, miscarriages, or infertility. Both sexes may lose sexual desire and the chances of producing sperms (spermatogenesis) or ova (oogenesis).
The drugs (2010) website explains that there are cases of severe, fatal dermatologic reactions including toxic epidermal necrolysis, Stevens Johnson syndrome, skin necrosis and many more occurs during or within a few days of taking the drug orally. It states that the most common dermatologic side effects include erythematous rashes, desquamation, epidermal necrosis, pruritus, urticaria, photosensitivity, pigmentary changes, ecchymosis, telangiectasia, acne, cutaneous vasculitis, furunculosis, and alopecia, and states the painful plaque erosions are uncommon.
According to the drugs (2010) website, there is a musculoskeletal side effect from having a low dosage of Methotrexate in patients with the rheumatoid arthritis and it includes rare instances of accelerated nodulosis. It explains that the problem is associated with Methotrexate and not the second line agent such as other drug taken whiles on the Methotrexate medication. The usage of Methotrexate may decrease the density of the bone in a syndrome known as Methotrexate osteopathy. This syndrome is very essential to women in their postmenopausal age.
There are also oncologic side effects on patients undertaking methotrexate and on the drugs (2010) website; it indicates that there are evidence which shows that methotrexate is oncogenic, mainly to the development of lymphoma and leukaemia.
Studies from drugs have shown that methotrexate has a cardiovascular side effect including thrombophlebitis, arterial thrombosis, cerebral thrombosis, deep vein thrombosis, retinal vein thrombosis and pulmonary embolus have been identified during the use of high dose of undertaking the methotrexate drug but pericarditis, pericardial effusion, myocardial ischemia, hypotension and ventricular arrhythmias have not been reported and therefore not seen or known as side effects.
Research on the drugs (2010) website have also identified that undertaking methotrexate affects individuals' or patients endocrine system. it is understood that the side effect only occurs in patients with rheumatoid arthritis and its associated with the use of having a low dose of methotrexate. Side effects include gynecomastia.
The drugs (2010) website shows that there are ocular side effects. The side effects include serious visual changes of unknown region and conjunctivitis.
It has been written on the drugs (2010) website that there are other side effects which include rare cases of bone and soft tissue necrosis following radiation therapy in patients receiving methotrexate.
COMPARISON OF METHOTREXATE WITH PACLITAXEL
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There are many different drugs that are used to treat patients with any type of cancer. According to the emed-tv (2010) website, paclitaxel is a chemotherapy drug prescribed to treat patients with breast, ovarian and lung cancer. The encyclopedia (2010) states that paclitaxel is a naturally occurring compound extracted from the bark of the pacific yew tree and was approved by the FDA in 1992. It is an antineoplastic agent functioned to inhibit cell replication. Paclitaxel is also used to treat patients with breast cancer that has recurred or progressed treatment with other drugs.
The chemical structure is
WHAT IS THE INGREDIENT OF PACLITAXEL?
WHAT ARE THE SIDE EFFECTS OF PACLITAXEL?
As with all medicines, there are possible side effects. However not everyone who consumes any medication will experience side effects and if side effects occur, they will either be minor, require no treatment or could be easily cured by a health care provider.
The emed-tv (2010) website shows how paclitaxel has been studied thoroughly and therefore side effects have been documented. It is understood that in most cases paclitaxel has either short-term or long-term side effects on patients undertaking the drug. Studies have shown that there are common and short-term side effects and they are Neutropenia; this happens when patients undertaking the drug have low levels of neutrophils in their white blood cells. Researchers have proved that in up to 100 percent of patients undertaking the paclitaxel drug will experience it. Anaemia; patients will also become anaemic and deficiency of iron in a red blood cell are the cause. It is proved that up to 97 percent of patients taking the paclitaxel drug will experience it. 96 percent of patients undertaking the paclitaxel drug experience hair lose. This is because the chemotherapy affects all the fast growing cancer cells in a human body and in addition, as well as killing the cancer cell, it also kills the fast growing normal cells. It has also been shown that up to 93 percent of patients experience joint and muscle pain. This is because the nervous system is affected and therefore there is an irritation of the nerves in individual's body. The breast cancer (2010) website states that, patients will experience tingling and numbness in their hands and feet as well as experiencing pain, tiredness, sore and weakness of the muscle. Studies from the emed-tv website have also shown that 93 percent of patients undertaking the paclitaxel drug will have the experience of nausea and this may result in them vomiting. 90 percent patients will also have low levels of leukocytes in the white blood cell and result in Leukopenia. It also states that 90 percent of patients taking the paclitaxel drug will diarrhoea. The breast cancer (2010) website also states that patients undertaking the paclitaxel drug may experience mucositis; this is because the mucus in the membrane of the mouth is irritated. Amenorrhea; this occurs in women and it is when the menstrual cycle stops. It also states that patients' finger nails become very brittle and yellow. Other side effects may include low platelet counts in the blood which may result in patients having clotting problems; sores in the digestive tract and the mouth, this is because the chemotherapy makes tissues dry and irritated which causes the stomach and the mouth to bleed. A change in the heart rhythm occurs as well, and this is seen with an electrocardiogram. Patients' may experience low blood pressure and slower heart rate.