A Drug Study on leucovorin

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A Drug Study Presented to 

The faculty of Nursing Department
Josephine Magno, RN, MN

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In Partial fulfilment of the

Requirements in NCM-212

By:

Karl Angelo Montano, Stn

BSN 3B

September 10, 2020

Generic Name: leucovorin

Brand Name:  Wellcovorin

CLASSIFICATION: Vitamin/folic acid antagonist antidote

Mode of Action: Needed for normal growth

Therapeutic outcome: patterns; prevents toxicity during antineoplastic therapy by

protecting normal cells reversal of severe toxic effects of folic acid antagonists

INDICATION: Megaloblastic or macrocytic anemia caused by folic acid deficiency,

overdose of folic acid antagonist, methotrexate toxicity, toxicity caused by
pyrimethamine/trimethoprim/trime-trexate, pneumocystosis, toxoplasmosis

CONTRAINDICATION: Hypersensitivity to this product or folic acid, benzyl alcohol,

anemias other than megaloblastic not associated with vit B12 deficiency

ADVERSE EFFECTS:

HEMA: Thrombocytosis (intraarterial)

INTEG: Rash, pruritus, erythema, urticaria

RESP: Wheezing

NURSING RESPONSIBILITIES:

Assessment

• Obtain CCr before leucovorin rescue and daily to detect nephrotoxicity,

methotrexate level

• Monitor I&O, urine pH q6hr; maintain at .7 to prevent neurotoxicity; watch for

nausea and vomiting; if vomiting occurs IM or IV route may be necessary

• Assess products currently taken: alcohol, hydantoins, trimethoprim may cause

increased folic acid use by body
• Assess for allergic reactions: rash, dyspnea, wheezing

• Assess neurologic status (rescue), weakness, fatigue

• Monitor calcium levels

• Assess for megaloblastic anemia, plasma lactic acid, reticulocyte count, Hct, Hgb

Patient/family education

• For leucovorin rescue: Drink 3 L fluid day of rescue

• Advise patient to take product exactly as prescribed; to notify prescriber of side

effects immediately

• Advise patient to report signs of hypersensitivity reaction immediately

• Advise patient with folic acid deficiency to eat folic acid–rich foods: bran, yeast,
dried beans, nuts, fruits, fresh green leafy vegetables, asparagus

• Advise patient to avoid breastfeeding

Evaluation Positive therapeutic outcome

• Increased weight

• Improved orientation, well-being

• Absence of fatigue

• Reversal of toxicity: methotrexate, folic acid antagonist overdose

References

Vallerand, A.H. (2009). Davis’s Drug Guide for Nurses. F.A. Davis Company. Philadelphia.
(11th ed.)

Karch, A.M.(2011). Lippincott’s Nursing Drug Guide. Lippincott Williams Rwilkins. Rochester,
New York.

Hodgson, B.B.(2011).Saunders Nursing Drug Handbook. Elsevier Saunders. St. Louis,

Missouri.

Roth, Linda Skidmore.(2011). Mosby’s Nursing Drug Reference. Mosby’s Inc. St. Louis,
Missouri.