Methotrexate is a medication used to treat cancer as well as some autoimmune diseases like rheumatoid arthritis. In this mnemonic video, I'll teach you an easy way to remember everything you need to know about methotrexate. Let's get started.
For today's video, we're hopping on the filming set for the movie The Matrix. You know, the movie with Keanu Reeves about an altered reality? Well, The Matrix can help you remember today's drug, methotrexate.
You know, since matrix kind of sounds like methotrexate. Let's start off by talking a little bit about how methotrexate works. This take of the movie is not going as planned, and the movie director has just about had it.
In his frustration, he is ripping the folder with the script in half. Here at Pixerize, we use a folder to represent folate. In this case, the folder here is being ripped because methotrexate works as an antifolate.
or a folate antagonist. By blocking folic acid signaling, methotrexate is able to stop DNA replication and therefore stop cell division. Why would that be useful? Well, let's talk about that next.
In front of him, the movie director has catered a plate of yummy, buttery crab. You know, since movie directors are rich and famous, they are always eating high-end food. Here at Pixerize, we use a crab to symbolize cancer.
just like the zodiac sign for cancer is a crab. Methotrexate is a form of chemotherapy that is useful in stopping the rapid cell division that occurs with cancer. But it actually does more than just treat cancer, so let's talk about that next.
The Matrix has this famous scene of Keanu Reeves bending over backwards to dodge bullets, remember? On the set, the bullets are exploding behind Keanu, and a film crew member is containing the flames of the explosion with a fire extinguisher. A fire extinguisher is our recurring symbol for anti-inflammatory agents.
Just like a fire extinguisher puts out inflammatory flames, methotrexate puts out inflammation. Because of its anti-inflammatory properties, methotrexate is also used to treat some autoimmune diseases that cause inflammation. You actually need to know just the most important disease for the NCLEX here, so we'll cover that next.
As Keanu Reeves was leaning way back for his stunt, He got distracted and lost his balance. The way he is banging his knee and elbow hard on the floor reminds me of the autoimmune disease rheumatoid arthritis because rheumatoid arthritis causes inflammation in your joints, like your knees and elbows. Like I mentioned before, the anti-inflammatory properties of methotrexate are used to reduce inflammation and treat rheumatoid arthritis.
Next, let's talk about some potential side effects of methotrexate. The movie director is the one who puts the scene in action. See that lever next to him? Well, when the director pulls that lever, the bullets shoot. In the Pixarized universe, we use a lever as our symbol for the liver.
Because liver and lever sound alike, right? Plus, the handle of this lever even looks like a liver, don't you think? This is here to help you remember that methotrexate can cause liver damage, also called hepatotoxicity.
The nurse will be responsible for monitoring the patient's liver enzymes. The patient should also be instructed to avoid alcohol and any other substances that harm the liver to prevent further damage. As the director pulled the lever, he bumped the table with his catered food.
In addition to the crab, which we already talked about, there is a pile of empty hollow bones. The director already ate the bone marrow out of these bones, and due to the bump, they are now falling to the floor. These hollow, empty, falling bones are here to help you remember that methotrexate causes bone marrow suppression, a common side effect of chemotherapy. The bone marrow is responsible for creating blood cells, like red blood cells, white blood cells, and platelets. So, bone marrow suppression leads to anemia, causing pallor and fatigue by reducing red blood cells, an increased risk of infection by reducing white blood cells, and a higher risk of bleeding by reducing platelet count.
We're getting closer to finding out what made Keanu Reeves lose his balance in the first place. Something was making him super nauseous. The way his face is green like that makes me think he's about to vomit. When you think of this movie actor feeling nauseous, remember that methotrexate can cause GI disturbances, like nausea, vomiting, diarrhea, and loss of appetite.
Methotrexate is also known to cause stomatitis, which refers to ulcers or canker sores forming inside the mouth. These gastrointestinal side effects may be treated with folic acid supplementation. If you remember earlier, we talked about how methotrexate is a folate antagonist, meaning that the drug works by blocking folate in the body.
So, giving folic acid actually slightly reverses the effects of methotrexate, including the nasty side effects. However, taking too much folate can make the drug completely ineffective. Because of this, patients should only take folic acid supplements after consulting with their provider.
Aha! The culprit of this whole fiasco is a tarantula crawling across the movie set. Keanu Reeves was disgusted by the creepy crawly guy, causing him to get nauseous and lose his balance. which in turn made the director angry and rip his folder.
See how it all came together? By the way, this tarantula is our symbol for teratogens. It's the teratogenic tarantula.
Methotrexate is a teratogen that can cause birth defects like spina bifida in the fetus and should not be given to pregnant women. Even after discontinuing the drug, it's advised that patients do not become pregnant for at least three months. If a patient taking methotrexate is found to be pregnant, the provider should be notified immediately. The patient will usually be given a high dose of folate supplementation to reverse the drug's effects as much as possible.
Alright, now that we've covered everything you need to know about methotrexate, let's summarize. Methotrexate is a medication that works by blocking or inhibiting folate. This blocks cell division, which can be used to kill rapidly divided cells like cancer cells.
Due to this, methotrexate is often used as a chemotherapy to treat various forms of cancer. It is also used for its anti-inflammatory effects to treat autoimmune diseases like rheumatoid arthritis. Side effects of methotrexate include hepatotoxicity, bone marrow suppression, and gastrointestinal disturbances, including stomatitis. Folic acid supplementation may help alleviate severe GI side effects, but remind patients to consult with their doctor beforehand.
Finally, methotrexate is teratogenic and should not be taken by pregnant women. We better let these guys get back to filming. Thanks for joining me on The Matrix Movie Set.
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