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March 1, 2021

Question of the Day – Monday March 1, 2021

What are the proposed mechanisms for methotrexate mediated neurotoxicity?

Chronic folate depletion; homocysteine excess through folate dependent methylation and alterations of biopterin and adenosine metabolism resulting in decreased neurotransmitter synthesis.

1. Subrahmanian KN et al. Evaluation and Management of Acute Onset Hemiparesis in an Adolescent with Leukemia. Pediatr Emerg Care 2018; 34: 347-e50.

2. Drachtman RA et al. Dextromethorphan is effective in the treatment of subacute methotrexate neurotoxicity. Pediatric Hematology and Oncology 2002; 19(5): 319-327.

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  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
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      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
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      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • E-Learning
      • Advanced Hazmat Life Support Training
      • MMTI Fundamentals for Front-Line Practitioners Training
      • ToxNow
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        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • Fellows of AACT
    • ToxCoach Mentorship Program
    • Committees
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      • Acute & Intensive Care
      • Clinical Toxicology In Sports
      • Herbs & Dietary Supplements
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      • Envenomations
      • Forensic
      • Pediatric
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