Condition: Newly diagnosed with rheumatoid arthritis, experiencing hand pain
Initial Treatment Recommendations:
Methotrexate: Suggested as a disease-modifying antirheumatic drug (DMARD)
Naproxen: Recommended for pain control until stabilized
Patient Concerns:
Methotrexate is questioned due to its immunosuppressant properties
Patient is a nurse and hesitant about immunosuppressive therapy
Cancer Cell DNA Replication
Cancer cells replicate DNA unregulated, incorporating nucleosides into DNA chains.
Vulnerability: Cancer cells incorporate compounds resembling nucleosides.
Role of Antimetabolites in Chemotherapy
Function: Exploit cancer cell vulnerability by acting as nucleoside analogs
Mechanism:
Analog Structure: Mimic substrates in pyrimidine and purine synthesis
Action: Serve as decoys which interrupt DNA synthesis
Outcome: Causes cell death by disrupting normal DNA synthesis
Key Points
Antimetabolites are crucial in chemotherapy for targeting rapidly replicating cancer cells.
Methotrexate, an example of an antimetabolite, can also be used in autoimmune conditions like rheumatoid arthritis, although it raises concerns about immunosuppression.
Considerations
Weigh the benefits of methotrexate in managing rheumatoid arthritis against potential risks of immunosuppression, especially in healthcare workers like GM.