Prescribing Safety Assessment (PSA) Practice Exam

The correct response is based on the understanding that using nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can increase the risk of toxicity when administered with methotrexate. Methotrexate is commonly used in the treatment of conditions such as rheumatoid arthritis and certain cancers. It works by inhibiting dihydrofolate reductase, leading to reduced folate levels and impact on cell proliferation.

When NSAIDs are used in conjunction with methotrexate, they can interfere with renal clearance of the drug, potentially leading to elevated serum levels of methotrexate. This elevation raises the likelihood of methotrexate's adverse effects, such as bone marrow suppression, gastrointestinal toxicity, and hepatotoxicity.

While acetaminophen, simvastatin, and amoxicillin may have their specific considerations when prescribed alongside methotrexate, they do not carry the same level of contraindication as ibuprofen. Acetaminophen is usually considered safer for pain relief in patients receiving methotrexate. Simvastatin is primarily used for lipid management, and amoxicillin is an antibiotic that does not significantly interact with methotrexate pharmacologically in a way that would contraindicate its use. In summary,