1. adverse effects
   1. myelosupression
   2. hepatotoxicity
   3. overwhelming sepsis
   4. pneumonitis
   5. cirrhosis or clinically evident liver disease
   6. mucositis, mild alopecia, and GI disturbances
2. data to pull
   1. history and examination
      1. fever
      2. bruising
      3. mouth ulcers
      4. respiratory signs and symptoms
         1. cough (new onset)
         2. shortness of breath
      5. nausea
   2. laboratory tests
      1. FBC
      2. U&Es
         1. creatinine
      3. LFTs
         1. alanine aminotransferase (AST)
         2. aspartate aminotransferase (AST)
      4. Urine dipstick
   3. risk factors
      1. use of antifolate agents such as trimethoprim
      2. presence of folate deficiency
      3. renal insufficiency
      4. prior history of hepatitis B or C
      5. obesity
      6. diabetes
      7. alcohol intake
      8. preexisting lung damage
      9. age
      10. duration of therapy
      11. folate depletion