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Methotrexate monitoring counselling — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsMethotrexate monitoring counsellingGPhC CRA

A patient taking weekly methotrexate develops new dry cough, fever, breathlessness and oxygen saturation 92%. What should the pharmacist do?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: EWithhold methotrexate and arrange urgent assessment for pneumonitis or infection

Methotrexate pneumonitis and serious infection can present with fever, cough, dyspnoea and hypoxaemia. Both are potentially life-threatening and require urgent assessment, chest investigation and treatment review. Trimethoprim adds dangerous marrow-toxicity risk.

Reference: BNF: methotrexate: https://bnf.nice.org.uk/drugs/methotrexate/