<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732020000600507</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v36i6.12678</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Intoxicação por metotrexato: relato de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Methotrexate intoxication: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ventura]]></surname>
<given-names><![CDATA[Ana Mafalda]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[Maria Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Franco]]></surname>
<given-names><![CDATA[Fátima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[Ana Luísa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Loures-Odivelas USF Cruzeiro ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Loures-Odivelas USF Ramada ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,ACeS Loures-Odivelas USF Novo Mirante ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>36</volume>
<numero>6</numero>
<fpage>507</fpage>
<lpage>510</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732020000600507&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732020000600507&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732020000600507&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Os medicamentos de alerta máximo têm um potencial de causar dano ao doente em caso de utilização incorreta, devido à gravidade dos seus efeitos adversos. O metotrexato (MTX) é um antimetabolito frequentemente utilizado no tratamento de doenças reumatológicas e um exemplo de medicamento de alerta máximo.  Descrição de caso:  Apresenta-se o caso de um doente de 64 anos que recorreu ao médico de família por quadro de disfagia, sensação de globus faríngeo, lesões cutâneas eritematosas pruriginosas e halitose. À observação apresentava extensa mucosite oral com edema da orofaringe. Após revisão terapêutica constatou-se que, por erro de interpretação, estaria a fazer diariamente 17,5mg de MTX com pausa semanal. Foi então referenciado ao serviço de urgência para observação por ORL e dermatologia e investigação adicional do quadro, nomeadamente de eventual toxicidade medular.  Comentário:  A forma mais comum de toxicidade por MTX é a sobredosagem acidental pelo doente, geralmente com efeitos secundários graves, podendo mesmo ser fatal. Este caso permite refletir sobre alguns aspetos importantes na segurança do medicamento com este tipo de fármacos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  High-alert medications have an increased risk of causing significant patient harm when used incorrectly. Methotrexate (MTX) is an antimetabolite used in the treatment of rheumatologic diseases and an example of a high-alert medication. Case report: We present the case of a 64-year-old male who took daily 17,5 mg of oral MTX despite using this medication for several years. The patient was evaluated for dysphagia, pruritic skin rash, and halitosis. The physical examination revealed extensive oral mucositis and oropharyngeal edema. After therapeutic review, it was realized that the patient was taking the prescribed dose daily instead of weekly. He was then referred to the emergency room to evaluate medullary involvement.  Comment:  Patient accidental intoxication is the most common cause of MTX toxicity, frequently with severe side effects, which can be fatal. This case report allows reflecting on some important aspects of medication safety with this type of drug.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Intoxicação]]></kwd>
<kwd lng="pt"><![CDATA[Metotrexato]]></kwd>
<kwd lng="pt"><![CDATA[Medicamentos de alerta máximo]]></kwd>
<kwd lng="pt"><![CDATA[Segurança na medicação.]]></kwd>
<kwd lng="en"><![CDATA[Intoxication]]></kwd>
<kwd lng="en"><![CDATA[Methotrexate]]></kwd>
<kwd lng="en"><![CDATA[High-alert medication]]></kwd>
<kwd lng="en"><![CDATA[Medication safety.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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