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High-Dose Methotrexate: Nursing Considerations for Administration and Supportive Care
Breanne Roche, Patricia A Clarke, Danielle Ford1
1Huntsville Hospital.
Clinical Journal of Oncology Nursing
|September 7, 2023
Summary
Nurses play a vital role in managing high-dose methotrexate (HDMTX) therapy. Early detection of delayed methotrexate elimination and supportive care are crucial for preventing severe toxicities in oncology patients.
Area of Science:
- Oncology Nursing
- Pharmacology
- Patient Management
Background:
- High-dose methotrexate (HDMTX) is a critical component of pediatric and adult cancer treatment.
- Delayed elimination of methotrexate can result in severe, life-threatening toxicities.
- A gap exists in literature regarding nursing management protocols for HDMTX, particularly concerning delayed elimination.
Approach:
- A comprehensive review of existing literature and clinical guidelines was conducted.
- The review focused on identifying essential nursing considerations for HDMTX administration and supportive care.
- Strategies for monitoring and managing delayed methotrexate elimination were evaluated.
Key Points:
- Nurses utilize various tools to closely monitor patients undergoing HDMTX therapy.
- Proactive nursing care and supportive measures are essential to mitigate HDMTX-related toxicities.
- Early identification of delayed methotrexate elimination is critical for timely intervention.
Conclusions:
- Effective nursing management is paramount in optimizing outcomes for patients receiving HDMTX.
- Prompt recognition and management of delayed methotrexate elimination, including the potential use of glucarpidase, can significantly reduce hospital stay and severe toxicities.
- This review highlights the crucial role of nurses in ensuring patient safety and improving treatment efficacy in HDMTX protocols.
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