Methotrexate in an OB setting

Does your hospital have a policy addressing hazardous drugs or chemotherapy? If you have chemo nurses in house, one should be able to come on down and give it.

We used to give methotrexate to ectopics in our outpatient chemo department (OB office would send them). You need to follow strict guidelines for the administration of hazardous drugs, as this is an antineoplastic agent. This means a gown and gloves, also a mask with eye protection if there is a potentation for splashing. Be sure to use a needle with a safety-lock device to avoid sticks. Any other questions, send me a PM.

Not just any gown and gloves, we use NIOSH recommended gown and gloves and proper chemotherapy disposal buckets. Our facility requires you to be chemo certified to give it. The previous facility I worked in had no standards for protection when given this drug that I knew of.

why do you give a chemo drug to ectopics? Sorry, I'm a psych nurse and don't know much about ob.

why do you give a chemo drug to ectopics? Sorry, I'm a psych nurse and don't know much about ob.

When diagnosed early, the ectopic pregnancy is confined to the fallopian tube and small enough that the tube is not in danger of rupture. Methotrexate is given to stop the growth of rapidly dividing cells (which applies to both malignant cells and embroynic cells). Methotrexate essentially terminates the pregnancy and allows the products of conception to be passed from the body without surgical intervention.

Surgery is avoided, if at all possible, because scarring and adhesions could impair a woman's future fertility and increase risk of preterm labor in future pregnancies.

http://www.webmd.com/baby/methotrexate-for-ectopic-pregnancy

why do you give a chemo drug to ectopics? Sorry, I'm a psych nurse and don't know much about ob.

Methotrexate is a folic acid inhibitor.......since folic acid is necessary for cell division, giving methotrexate will cause the embryo in an ectopic pregnancy to cease cell division (die), it is then reabsorbed by the body. It is only given for unruptured ectopic.

I got two doses of methotrexate when I had an ectopic several years ago, and I don't recall the nurse who administered the injections wearing anything more than gloves

Even after 2 doses I still ended up with laparoscopy and a D&C.