Methotrexate (MTX), is an antifolate drug that was first developed to treat certain types of cancer. The use in cancer therapy is at higher doses whereas its use in rheumatic diseases is at much lower doses. It was found that the addition of a maintenance therapy following remission comprising of 6 mercaptopurine daily along with methotrexate weekly resulted in higher chances of remission. As per the current ALL protocols, induction and consolidation therapy is followed by oral 6 MP/ methotrexate maintenance therapy is given until 2 to 3 years from diagnosis. The enzyme dihydrofolic acid reductase (DHFR), which acts by reducing dihydrofolates to tetrahydrofolates, is inhibited by methotrexate. The tetrahydrofolates that are formed by means of this enzyme are used in the synthesis of purine nucleotides and thymidylate as one - carbon carriers. Methotrexate, therefore, interrupts DNA synthesis, and interferes with its repair …show more content…
It is usually completely absorbed when administered parenterally.. About 50% of methotrexate in the serum is bound to plasma proteins. It can therefore be displaced by various compounds including sulfonamides, salicylates, tetracyclines, chloramphenicol, and phenytoin. Methotrexate, when given orally or parenterally, does not cross the blood-CSF barrier in therapeutic concentrations. However, intrathecal administration yields high CSF concentrations of the drug. Polyglutamated compounds are formed from methotrexate due to hepatic metabolism that may be also be reverted to form MTX by the enzymes hydrolases. The terminal half-life of methotrexate is nearly three to ten hours in those receiving doses less than 30 mg/m2 and can be 8 - 15 hours for those receiving higher doses of the drug. The primary route of elimination is renal and excretion and is dependent upon the dose as well as route of
However, the majority of known anti-cancer drugs target normal cells as well. Methotrexate, formerly known as amethopterin, is an antimetabolite used in the treatment of some forms of cancer (Shacter and Law, 1956). It inhibits the function of dihydrofolate reductase (DHFR) by tightly binding to the enzyme. Following this slow interaction between methotrexate and DHFR, an enzyme-NADPH-inhibitor complex is formed (Stone et al., 1984). Therein, DHFR is rendered unable to catalyze the NADPH-dependent reduction of dihydrofolate to tetrahydrofolate (Anderson, 2017). Tetrahydrofolate is an important methyl group shuttle in the de novo synthesis of purine and pyrimidine nucleotides and some amino acids (Barbara and Hiroshi, 2002). Therefore, eliminating it from cells is a good therapeutic strategy against cancer cells, as it would limit the de novo synthesis of purines and pyrimidines (Lane and Fan, 2015). Inhibiting the function of DHFR by its competitive inhibitor methotrexate is one such good therapeutic strategy, as it would disable DHFR from converting dihydrofolate into tetrahydrofolate. However, some types of cancer cells had acquired some forms of resistance against methotrexate (Hans et al., 2011). Equally important, methotrexate should be administered in well established low doses, because it affects
Several of the officers of the company seem reluctant to contact the processor even though the math on the invoice is not correct. The invoice indicates that approximately $500,000 of the sales (2,000 items) are at 0.1% plus $.22. This would be the interchange price for a regulated debit card after add a markup of .05%. It also shows approximately $ 150,000 (300 items) at 1.48% plus $.05. When you do the math, you conclude that the total cost should be $3,175. You would expect this amount to carryforward to the front of the invoice, but it does not.
Courage is to overcome a difficult subject or situation. Adversity is a difficult situation or subject. People need to have courage to overcome adversity. Many people, specifically women endure hardships and adversity. In order to overcome adversity, one must demonstrate courage. This will be demonstrated through the Sources A and D, “Ain’t I a Woman,” spoke by Sojourner Truth (Source A) and an Anti-suffrage Political Cartoon (Source D).
It’s important to visit a healthcare facility once an individual encounters signs of polycystic ovary syndrome and the physician may prescribe Metformin to treat PCOS.
Deferoxamine mesylate can be used for treating acute iron intoxication. Deferoxamine complexed with iron to form ferrioxamine and then prevented the iron from entering into further chemical reactions. The formed chelate is readily soluble in water and passes easily through the kidney [1].
Diclofenac is 100% absorbed after oral administration compared to IV administration as measured by urine recovery. However, due to first-pass metabolism, only about 50% of the absorbed dose is systemically available .Food has no significant effect on the extent of diclofenac absorption. However, there is usually a delay in the onset of absorption of 1 to 4.5 hours and a reduction in peak plasma levels of < 20%. Diclofenac is primarily metabolized by CPY2C9. Diclofenac is eliminated through metabolism and subsequent urinary and biliary excretion of the glucuronide and the sulfate conjugates of the metabolites
Methotrexate is a competitive inhibiter of binding of dihydrofolic acid (FH2) to the enzyme dihydrofolate reductase (DHFR). METHOTREXATE is a structural analogue of folic acid which make it can easily bind to the same receptor. DHFR is responsible for reducing FH2 to folinic acid (FH4), the active intracellular metabolite. Thus, METHOTREXATE decreases the amount of intracellular FH4 available and affects the metabolic pathways within the cell that are FH4 dependent. These pathways include pyrimidine metabolism and purine, polyamine synthesis and amino
The bioavailability of the carboxylate is estimated to be approximately 80%, and the time to maximum plasma concentration of the carboxylate is between 2.5 and 5 hours.
Metformin is widely used to treat type 2 diabetes who do not have severe nephritis, cardiovascular disease or liver disease. It is one of the best first line treatment for type 2 diabetes which was first marketed named as Glucophage. Metformin also used in the treatment of polycystic ovary syndrome and increasing the use day by day.
Patients suffering from rheumatoid arthritis are advised by doctors to start treatment with disease-modifying antirheumatic drugs (DMARDs). DMARDs help relieve the symptoms as well as the progression from joint damage. A common DMARD used in relieving the symptoms and stopping the progression of joint damage is Methotrexate. “Although biologic agents were first established as combination therapy with DMARDs such as MTX, Gómez-Reino discusses data from clinical trials in which biologic monotherapy was used as an effective treatment for patients with RA”(Smolen & Keystone ,2012). DMARDs such as methotrexate is an effective treatment for treating the symptoms of Rheumatoid Arthritis. DMARDs are often prescribed along with nonsteroidal anti-inflammatory drugs (NSAIDs) to assist in reducing swelling and
My life began in Bialystok, Grodno Governorate which is now Poland. Shortly after my birth my family and I moved to Kiev and I would eventually attend and graduate from Kiev Art School in two years. In that same year, I married a Kiev lawyer named Nicoloas Evgenievish Ekstar and moved to Paris for several months and studied at Academeie de la Grande-chaumiere in Paris, I was expelled for not following their artistic ideas. I would later on meet Pablo Picasso, Guillaume Apollinaire, Max Jacob and Fernand Léger in Paris and would become inspired by cubism. (“The reduction of natural forms to their geometrical equivalents, and the organization of the planes of a represented object independently of representational requirements.”) The Cubism movement would have inspired my first exhibit (publicly display (a work of art or item of interest) in an art gallery or museum or at a trade fair.) in Kiev and later on St. Petersburg called “Exhibition of New Currents.” Within the same year, I organized an Impressionistic (a person who follows or adhees to the theories, methods, and practices of impressionism) learning called “zveno” (“link”) with David Burlyuk, Mikhail Larionov, Natalya Goncharova. I would later move back to Paris, rent my own
Methotrexate has as its principal mechanism of action the competitive inhibition of the enzyme folic acid reductase. Folic acid must be reduced to tetrahydrofolic acid by this enzyme in the process of DNA synthesis and cellular replication. Methotrexate
Antionette, I really enjoyed reading your post as it was well written and you have some really good ideas. One of the most important things that you mentioned was that police officers must know the department’s expectations of them, especially that of personal conduct. This will make the supervisor’s job much easier as the officer will know what activities and actions will not be tolerated. The second most important idea was how important the public’s trust is. Look at Ferguson, Missouri, where trust had been lost for many years. The public did not trust the police, even when it was proven that they did no wrong. Not investigating civilian complaints against officers is the easiest way to lose that trust. I have found that many
Before watching "Opiate Addiction: A new medication". I did hear about replacement therapy and like most people I thought it was a substitute for the actual drug. After watching the video I realized the importance of replacement therapy. Methadone doesn't just treat the withdrawal symptoms of opiate addiction, it treats the brain itself. Methadone corrects the chemical changes in the brain causes by the opiates.
Genesis 12:1 is one of the most powerful verses in Genesis. The Bible shows us a man, a man that a huge, life changing choice in front of him. Abram had a life and a family, he settled down in the land of Harran. One day the lord of lords, Elohim himself established a enormous calling and purpose over his life. God told Abram to leave his home, his family, and everything he had known to follow him. God wanted Abram to focus on the journey not the destination. Many times in our life for the purpose of God to be fulfilled in our life we bust leave everything we know. We most go to the land that God will show us. Like Abram we will not know the land but we will know our calling. This verse is about faith, faith in the unknown. We must learn to have complete faith in God, even if our human eyes show us the oposite of our promise, even if God's promise seem impossible. We must understand that he is the God of the impossible, the one that can make all new.