Question

using the data answer the questions

0 Clinical values are reported to one decimal place; please report your final calculations accordingly. Must show calculations and units for credit. Please put answers in the space provided. (1) You are monitoring a 60 yrs, old male who began taking a drug with known Folate antagonist ("antifolate") properties 9 weeks ago and is now half way through his treatment gimen. His current lab values are: (14 points | REC# (x 1015 | MCV [1 SD] (L) | 102.9 1 16.3] RBC folate (nmol/L) 210.3 Serum Folate (nmoVL) 6.5 32.1210.3.01 4.01 Based on these values, fill in the tables below: Calculation Answer (with units) 41.3% Uin 4.c1 지 12.9 9/dL 32.1 x401/D HgB MCHC RDW 31-49oL 15.9 % lozs Based on these values, is he anemic? (Yes/No) Based on: Low Het / Low HgB / Both Low/ Both Normal (choose one) Describe his current RBC Morphology (circle all that apply): normocytic microcytic hyperchromic normochromic hypochromic Is there evidence that he has been compliant in taking the medication with anti-folate properties? (Yes /No) Provide brief rationale for your answer:

Answer 1

* I think there is no evidence that has been a complaint in taking the medication with anti-folate properties. Normally antifolate agents were the first class of antimetabolites. Their mechanism of action is due to the disruption of the metabolic pathways that require one-carbon moieties supplied by the B9 folate vitamins which they resemble. While renewing tissues of the bone marrow and intestinal tract are also folate-dependent and are sites of antifolate toxicity, the clinical utility of antifolates was established with the identification of doses and schedules of administration that provided sufficient selectivity to make these drugs effective in the treatment of cancer as well as inflammatory disorders.

* A 3-week treatment with antifolates interval was feasible in the majority of patients at all doses.  if in case there may be toxicity that leads to neutropenia, and hepatic toxicity was the most common dose-limiting toxicities. Here the treatment is started 9 weeks ago and we have to consider the CBC as well as LFT mainly SGOT, SGPT and ALP as well as GGT in rare cases.

* Here the antifolate agents will be acted on the bone marrow and results in the longest to change the CBC panel