Re: Methotrexate
From: art fougner, md (evsono@pipeline.com)
Mon Apr 30 12:26:47 2007
Dan and Steve
I second that emotion.
Art
At Mon, 30 Apr 2007, R. Daniel Braun wrote:
>
>So it looks like therre is a higher number o fpatients requiring 2 or 3
>courses of treatment. The total number of pregnancies is way too small to
>conclude that.
>Steve,
>Publish your data!
>
>Dan
>
>On 4/29/07, art fougner, md <evsono@pipeline.com> wrote:
>>
>> Am J Obstet Gynecol. 2002 Jun;186(6):1192-5.
>> Oral methotrexate for treatment of ectopic pregnancy.
>> Lipscomb GH, Meyer NL, Flynn DE, Peterson M, Ling FW.
>>
>> Department of Obstetrics and Gynecology, University of Tennessee Health
>> Science Center, Memphis, USA.
>>
>> OBJECTIVE: The purpose of this study was to evaluate oral methotrexate
>> tablets in the treatment of ectopic pregnancy. STUDY DESIGN: Patients
>> with a diagnosis of ectopic pregnancy were offered oral methotrexate
>> tablets rather that intramuscular injection. Oral methotrexate was
>> given in 2 divided doses 2 hours apart at a dose of 60 mg/m(2) with
>> standard 2.5 mg methotrexate tablets. Patients were followed up with
>> the use of the same protocol that was used typically for intramuscular
>> methotrexate. RESULTS: Nineteen of 22 patients (86%) were successfully
>> treated. There was no statistical difference between patients who were
>> treated successfully or unsuccessfully, with respect to initial human
>> chorionic gonadotropin titers (P =.55), ectopic size (P =.77), or
>> methotrexate dose (P =.18). Nineteen of 22 patients (86%) had increased
>> pain during treatment. Outside of pain, gastrointestinal side effects
>> were the most common. Thirty-two percent of patients required more than
>> one treatment cycle. CONCLUSION: Oral methotrexate can be used to treat
>> ectopic pregnancy successfully, but there are few advantages to
>> recommend its use over intramuscular methotrexate.
>>
>> Art
>>
>> At Sun, 29 Apr 2007, R. Daniel Braun wrote:
>> >
>> >Steve,
>> >Give us a reference ofr that. OR put all your data together and publish
>> it.
>> >Dan
>> >
>> >On 4/29/07, Raymond Stephen <stephen.raymond@dhhs.tas.gov.au> wrote:
>> >>
>> >> Yes I have used oral exclusively in the last decade. The dose is the
>> >> same, but be aware that it is available in small dose tablets (I think
>> 2 or
>> >> 2.5mg), so ensure that he stocks the larger dose tablets otherwise your
>> >> patients have to swallow 20 tablets at a time!
>> >>
>> >> Steve Raymond
>> >>
>> >> ------------------------------
>> >>
>> >> ------------------------------
>> >> ------------------------------
>> >> ------------------------------
>> >> ------------------------------
>> >> ------------------------------
>> >> ------------------------------
>> >> *From:* ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] *On Behalf Of
>> *Elrod,
>> >> ------------------------------
>> >> Darryl G Maj 48 MDOS/SGOBO
>> >> ------------------------------
>> >> ------------------------------
>> >> ------------------------------
>> >> *Sent:* Friday, 27 April 2007 6:47 PM
>> >> ------------------------------
>> >> *To:* Multiple recipients of list OB-GYN-L
>> >> ------------------------------
>> >> *Subject:* Methotrexate
>> >> ------------------------------
>> >>
>> >> Does anyone have any experience with ORAL methotrexate for treatment of
>> >> ectopic pregnancy? Our pharmacist is looking to try and get away from
>> >> having to stock IM methotrexate.
>> >>
>> >> Thanks,
>> >>
>> >> Glen
>> >>
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>> >--
>> >R. Daniel Braun, MD FACOG(L) CMT
>> >Professor Emeritus
>> >Dept. of Obstetrics and Gynecology
>> >Indiana U. School of Medicine
>> >
>> >R. Daniel Braun
>> >
>> > "The way to health is an aromatic bath and scented massage
>> everyday".
>> > Hippocrates
>> >
>>
>> --
>> art fougner, md
>> "May The Wings of Liberty Never Lose a Feather." - Jack Burton
>>
>--
>R. Daniel Braun, MD FACOG(L) CMT
>Professor Emeritus
>Dept. of Obstetrics and Gynecology
>Indiana U. School of Medicine
>
>R. Daniel Braun
>
> "The way to health is an aromatic bath and scented massage everyday".
> Hippocrates
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
