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[1] [2] When initiated by the clinician, it is known as deprescribing. [3] Medication discontinuation is an important medical practice that may be motivated by a number of reasons: [4] [3] Reducing polypharmacy; Reducing health expenditure
Methotrexate was originally developed and continues to be used for chemotherapy, either alone or in combination with other agents.It is effective for the treatment of several cancers, including solid tumours of breast, head and neck, lung, bladder, as well as acute lymphocytic leukemias, non-Hodgkin's lymphoma, osteosarcoma, and choriocarcinoma and other trophoblastic neoplasms.
Methotrexate inhibits Folic Acid reductase which is responsible for the conversion of Folic Acid to tetrahydrofolic acid. At two stages in the biosynthesis of ppurins and at one stage in the synthesis of Pyrimidines, one-carbon transfer reactions occur which require specific coenzymes synthesized in the cell from tetrahydrofolic acid.
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Mercaptopurine (6-MP), sold under the brand name Purinethol among others, is a medication used for cancer and autoimmune diseases. [2] Specifically it is used to treat acute lymphocytic leukemia (ALL), acute promyelocytic leukemia (APL), Crohn's disease, and ulcerative colitis. [2] [3] For acute lymphocytic leukemia it is generally used with ...
Folinic acid, also known as leucovorin, is a medication used to decrease the toxic effects of methotrexate and pyrimethamine. [2] [3] It is also used in combination with 5-fluorouracil to treat colorectal cancer and pancreatic cancer, may be used to treat folate deficiency that results in anemia, and methanol poisoning.
For example, methotrexate is used as cancer chemotherapy because it can prevent neoplastic cells from dividing. [1] [2] Bacteria also need DHFR to grow and multiply and hence inhibitors selective for bacterial vs. host DHFR have found application as antibacterial agents. [3] Tetrahydrofolate synthesis pathway
Pemetrexed is also recommended in combination with carboplatin and pembrolizumab for the first-line treatment of advanced non-small cell lung cancer. [12] [13] However, the relative efficacy or toxicity of pemetrexed-cisplatin versus pemetrexed-carboplatin has not been established beyond what is generally thought about cisplatin or carboplatin doublet drug therapy.