In a patient with rheumatoid arthritis being treated with methotrexate, what should be monitored after increasing the dose?

Monitoring a complete blood count (CBC) and blood chemistry profile is crucial after increasing the methotrexate dose in a patient with rheumatoid arthritis. Methotrexate can have significant effects on bone marrow, leading to potential cytopenias, such as anemia, leukopenia, or thrombocytopenia. Therefore, regular monitoring of the CBC helps to ensure that the patient is not developing any hematologic complications as a result of the medication.

Additionally, methotrexate can impact liver function, and a blood chemistry profile will provide insights into liver enzymes and kidney function. Changes in these levels can indicate potential toxicity from methotrexate, warranting adjustments in treatment or further investigation.

Other options, while relevant to patient management, do not hold the same immediate priority following a dose adjustment. Monitoring vitamin D levels could be beneficial, especially in patients at risk of deficiency, but it is not the primary focus after a dosage increase of methotrexate. Similarly, assessing bone density is typically a longer-term consideration for patients on glucocorticoids or those with risk factors for osteoporosis, and inflammatory markers help gauge disease activity rather than medicine safety or toxicity. Thus, the priority remains on hematologic and biochemical parameters after a dosage increase in meth