Step I pharm ? regarding methotrexate

[patuit79]

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A 42 year old woman has dizziness and ringing in her ears 7 days after starting a drug. Which is the cause?
A) acetominophen
B) aspirin
C) auranofin
D) methotrexate
E) prednisone

I chose mxt but not sure about it causing that side effect. does anyone know the answer?

 

[darice]

I believe those are common side effects of acetominophen....

 

[jameslynton]

Methotrexate - used in chemo therapy in cancer along with some of the other drugs does cause hearing loss but does not cause tinninus. Methotrexate is also used to slow long nerve damage in MS in slow progressive cases. So you will see hearing loss there also - the key is to the correct agent in the question is 8 days. Methotrexate does not cause red blood cell loss for at least two weeks after use - if I remember correctly. Normally the RBC loss translates as being tired.

 

[Idiopathic]

Um...how can this not be aspirin? Tinnitus is one of the first signs of ASA intoxication. SO many drugs cause dizziness and ringing, but its classically associated with ASA toxicity.

 

[TIMMY]

Um...how can this not be aspirin? Tinnitus is one of the first signs of ASA intoxication. SO many drugs cause dizziness and ringing, but its classically associated with ASA toxicity.

I agree...I dont know if it was Goljan that drilled this point home but I remember someone constanly saying the first classical symptom of ASA tox was Tinnitus....then the other stuff like respiratory alkalosis and metabloic acidosis (Both in adults and Kids more susceptible to MA )follow.

 

[woowoo]

aspirin it is. MTX's main toxicities are myelosuppression (relieved by leucovorin, and fatty liver.

 

[Idiopathic]

Come on guys, this ones a gimme.

 

[surgwannabe]

Come on guys, this ones a gimme.

AGREE! Just for your info, triad for the ASA overdose: fever, tinnitus, and initial respiratory alkalosis

 

[OSUdoc08]

I agree...I dont know if it was Goljan that drilled this point home but I remember someone constanly saying the first classical symptom of ASA tox was Tinnitus....then the other stuff like respiratory alkalosis and metabloic acidosis (Both in adults and Kids more susceptible to MA )follow.

Yeah, it was Goljan.

It's obviously ASA.