Biologic agents: Nursing pharmacology

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BIOLOGIC AGENTS, PART 1 | ||
DRUG NAME | etanercept (Enbrel), infliximab (Remicade, Renflexis, Avsola, Inflectra), adalimumab (Humira) | |
CLASS | TNF blockers | |
MECHANISM OF ACTION | Prevent TNF from attaching to its receptor → suppress immune response | |
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION |
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SIDE EFFECTS |
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CONTRAINDICATIONS AND CAUTIONS |
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BIOLOGIC AGENTS, PART 2 | |||
DRUG NAME | anakinra (Kineret) | tocilizumab (Actemra, Actemra ACTPen) | secukinumab (Cosentyx, Cosentyx Sensoready Pen) |
CLASS | IL-1 inhibitor | IL-6 inhibitor | IL-17A inhibitor |
MECHANISM OF ACTION | Prevent IL-1, IL-6, or IL-17A from attaching to their receptors → suppress immune response | ||
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION |
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SIDE EFFECTS |
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CONTRAINDICATIONS AND CAUTIONS |
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NURSING CONSIDERATIONS: BIOLOGIC AGENTS | ||
ASSESSMENT AND MONITORING | Infliximab for Crohn disease Assessment
Interventions and monitoring
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CLIENT EDUCATION |
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Memory Anchors and Partner Content
Transcript
Biologic agents are a group of medications used to treat various inflammatory conditions, including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis, and Crohn’s disease.
Now, biologic agents can be broken down into two main classes: tumor necrosis factor, or TNF blockers, which include etanercept, infliximab, and adalimumab; and interleukin inhibitors, which include interleukin- 1 or IL-1 inhibitors, like anakinra, interleukin- 6, or IL-6 inhibitors, like tocilizumab, and interleukin- 17A, or IL-17A inhibitors, like secukinumab.
These biologic agents are administered subcutaneously, and as their names suggest, the way they work is by inhibiting their respective inflammatory cytokines, so TNF, IL-1, IL-6, or IL-17A, ultimately preventing them from attaching to their receptors.
As a result, these medications help suppress the immune response in clients with inflammatory conditions.
Now, clients on biologic agents might develop a skin rash or injection site reactions, such as erythema, mild pain, and discomfort.
A major side effect of biologic agents is bone marrow suppression, which can put the client at increased risk of infection.
In fact, most TNF blockers have a boxed warning for the development of severe infections, such as tuberculosis, as well as lymphoma and other neoplastic diseases.
Additionally, TNF blockers have been associated with headaches and demyelination of the nervous system, as well as myocardial infarction, heart failure, stroke, hypotension, and some clients may develop hypersensitivity reactions, such as Stevens Johnson syndrome or toxic epidermal necrolysis.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Lehne's Pharmacology for Nursing Care" Elsevier Health Sciences (2014)