[Wrong administration of methotrexate can lead to fatal haematological complications in elderly patients]

Area of Science:

• Pharmacology
• Rheumatology
• Toxicology

Background:

• Methotrexate is a common medication for rheumatological diseases.
• Accurate dosing schedules are crucial for patient safety.

Observation:

• Four cases of severe methotrexate intoxication were reported in patients with rheumatological conditions.
• Two cases resulted from accidental daily administration instead of the intended weekly schedule.
• Patients exhibited non-specific symptoms like nausea, mucositis, and fever.

Findings:

• All patients developed pancytopenia, a severe drop in all blood cell types.
• Despite broad-spectrum antibiotic therapy, three patients succumbed to septic shock.
• The study underscores the severe consequences of methotrexate dosing errors.

Implications:

• Highlights the critical need for clear communication among healthcare professionals regarding methotrexate administration.
• Emphasizes the importance of strict adherence to weekly dosing protocols for methotrexate.
• Suggests potential system-based interventions to prevent medication administration errors.