ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
What is the phamacologic agent of choice for medical management of ectopic?
Methotrexate (MTX)
MOA of methotrexate?
Folic acid antagonist, interferes with DNA synthesis & cell division of actively proliferating cells
What are the potential problems associated with methotrexate?
- drug-related side effects (with shortterm use, usually GI
- tx-related complications (temporary abdominal pain, vaginal spotting &/or bldg, increased hCG levels x
first 1-3 days after
treatment)
- tx failure with tubal rupture & hemorrhage or possible persistent ectopic, requiring surgical
intervention
What patient counseling is necessary before administering methotrexate?
- explanation of treatment plan & importance of follow-up
- advise regarding possible adverse effects
- explain likelihood of transient abdominal/pelvic pain & distinguish from severe or increasing pain of
tubal rupture
- avoid gas-producing foods, intercourse, alcohol, NSAIDS, vitamins containing folic acid, penicillin, sun
exposure
What substances should a woman taking methotrexate for ectopic avoid?
gas-producing foods
intercourse
alcohol
NSAIDS
vitamins containing folic acid
penicillin
sun exposure
How is methotrexate usually given in the case of ectopic?
IM injection
What labs should you do prior to methotrexate administration?
baseline values for bhCG, creatinine level, liver enzyme tests, CBC, platelets, blood type + Rh factor
What is salpingectomy?
LATEST UPDATE (GRADED A+)
What is the phamacologic agent of choice for medical management of ectopic?
Methotrexate (MTX)
MOA of methotrexate?
Folic acid antagonist, interferes with DNA synthesis & cell division of actively proliferating cells
What are the potential problems associated with methotrexate?
- drug-related side effects (with shortterm use, usually GI
- tx-related complications (temporary abdominal pain, vaginal spotting &/or bldg, increased hCG levels x
first 1-3 days after
treatment)
- tx failure with tubal rupture & hemorrhage or possible persistent ectopic, requiring surgical
intervention
What patient counseling is necessary before administering methotrexate?
- explanation of treatment plan & importance of follow-up
- advise regarding possible adverse effects
- explain likelihood of transient abdominal/pelvic pain & distinguish from severe or increasing pain of
tubal rupture
- avoid gas-producing foods, intercourse, alcohol, NSAIDS, vitamins containing folic acid, penicillin, sun
exposure
What substances should a woman taking methotrexate for ectopic avoid?
gas-producing foods
intercourse
alcohol
NSAIDS
vitamins containing folic acid
penicillin
sun exposure
How is methotrexate usually given in the case of ectopic?
IM injection
What labs should you do prior to methotrexate administration?
baseline values for bhCG, creatinine level, liver enzyme tests, CBC, platelets, blood type + Rh factor
What is salpingectomy?
