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What is Alkalinisation of urine ameliorates the toxicity of which of the following drugs? and explain in detail?
METHOTREXATE: High-dose therapy requires adequate hydration and urine alkalinization Delay methotrexate if severe myelosuppression, hepatotoxicity, mucositis, or pleural effusion present. Acetazolamide, 500 mg 6 hourly, has been used to alkalinise the urine in patients receiving high dose methotrexate. A urinary pH of greater than 7.5 was achieved in every cycle (13 cycles in 10 patients). In 6 cycles a single supplementary dose of sodium bicarbonate was necessary. Plasma methotrexate levels fell satisfactorily at 24 and 48 h. Acetazolamide is a simple and effective method of achieving urinary alkalinisation with advantages over oral and intravenous bicarbonate. REFERENCE: www.medscape.com, www.ncbi.nlm.nih.gov