A 46-year-old woman with rheumatoid arthritis takes methotrexate for disease control. Following an accidental overdose, she presents with severe oral ulcers, pancytopenia (WBC 2.1 K/µL), and bone marrow suppression. Vital signs show HR 102 bpm, BP 118/76 mmHg, RR 18, temperature 37.2°C. She denies recent infections. Rescue therapy is initiated with a reduced folate analog that bypasses dihydrofolate reductase inhibition. Which agent was most likely administered?
- A)Protamine sulfate
- B)Cyanocobalamin
- C)Mesna
- D)Pyridoxine
- E)Folinic acid leucovorinGABARITO
Explicação
Leucovorin, also called folinic acid, rescues normal cells from methotrexate toxicity by bypassing dihydrofolate reductase and replenishing reduced folate pools. It is used when methotrexate causes significant myelosuppression or mucositis. Ver explicação completa e trilha adaptativa →