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Related Concept Videos

Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Phase II Reactions: Methylation Reactions01:17

Phase II Reactions: Methylation Reactions

Methylation is a phase II biotransformation process involving the attachment of a methyl group to a substrate. Enzymes known as methyltransferases orchestrate this reaction.
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Phase II Reactions: Glutathione Conjugation and Mercapturic Acid Formation01:22

Phase II Reactions: Glutathione Conjugation and Mercapturic Acid Formation

Glutathione, a tripeptide made up of glutamate, cysteine, and glycine, is a critical player in the detoxification of drugs and xenobiotics via a process known as glutathione conjugation or mercapturic acid formation. This phase II biotransformation reaction involves the covalent binding of glutathione to a drug or its metabolite, enhancing the compound's water solubility and enabling its excretion.
Several distinctive characteristics distinguish glutathione conjugation from other phase II...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase01:11

Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...
Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase01:27

Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase

Phase II biotransformation reactions are essential for detoxifying and eliminating xenobiotics, including many pharmaceutical compounds. These reactions typically involve conjugation, the covalent attachment of polar endogenous groups such as glucuronic acid, sulfate, methyl, or acetyl moieties to functional groups introduced during Phase I metabolism. The resulting conjugates are more water-soluble, enabling efficient renal or biliary excretion.The major classes of Phase II enzymes include...

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Related Experiment Videos

Four-year experience with methotrexate exposures.

Frank LoVecchio1, Kenneth Katz, David Watts

  • 1Banner Good Samaritan Regional Poison Center, Maricopa Medical Center, Department of Emergency Medicine, Phoenix, AZ, USA. Frank.LoVecchio@bannerhealth.com

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|September 30, 2008
PubMed
Summary
This summary is machine-generated.

Acute oral overdose of methotrexate (MTX) is uncommon. A review of poison center data found no significant toxicities in patients with unintentional MTX ingestion.

Related Experiment Videos

Area of Science:

  • Toxicology
  • Pharmacology
  • Clinical Medicine

Background:

  • Unintentional acute oral overdose of methotrexate (MTX) is infrequently documented in medical literature.
  • MTX is a common chemotherapeutic agent with known severe toxicity when administered intravenously.

Purpose of the Study:

  • To investigate the outcomes of acute oral MTX overdose.
  • To determine if oral MTX overdose presents similar toxicity risks as intravenous administration.

Main Methods:

  • A retrospective chart review was performed on human exposure calls related to MTX ingestions.
  • Data from 2000 to 2003 from a single Poison Center were analyzed, encompassing over 150,000 charts.

Main Results:

  • Thirteen patients met the inclusion criteria for the study.
  • The average ingested dose was 13.03 mg MTX (n=7), with an average patient age of 43 years (range: 20 months to 80 years).
  • No significant adverse toxicities were observed in the studied patients.

Conclusions:

  • Acute oral MTX overdose, whether unintentional or suicidal, does not appear to be associated with severe toxicity.
  • Findings suggest a lower risk profile for oral MTX ingestions compared to intravenous administration.