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Biologic DMARDs - etanercept (Enbrel) Cheat Sheet by

disease modifying antirheumatic drugs

Medication Names

Prototye Med
etenercept (Enbrel)
Other Meds
infliximab (Remicade)
adalimumab (Humira)
Drug Class: Antirh­eumatic
Action: inacti­vation of tumor necrosis factor resulting in reduced inflam­mation and immuno­sup­pre­ssion, tumor necrosis antago­nists.

Therap­eutic Use

DMARDs are drugs that treat and decrease joint inflam­mation, and subseq­uently prevent joint damag
Biologic DMARD drugs are tumor necrosis factor antago­nis­ts—­drugs that bind with naturally occurring tumor necrosis factor, preventing it from attaching to cells on the surface of synovial tissue in the joints

Adverse Drug Reactions

Increased suscep­tib­ility to infections
Dizziness, Abdominal Pain
Upper Respir­atory Infections
Rare occurrence of severe allergic reactions such as Steven­s-J­ohnson syndrome (SJS), toxic epidermal necrolysis (TEN), and erythema multiforme
Local injection site reaction
Heart failure
Reacti­vation of latent tuberc­ulosis (TB)

Nursing Interv­entions

Assess for infection prior to each injection.
Monitor for signs and symptoms of infection during therapy
Monitor for skin reactions
Monitor for redness, warmth, and itching at the injection site
Monitor clients for signs and symptoms of heart failure (cough, shortness of breath, elevated blood pressure and heart rate, pink sputum)
Administer TB test prior to starting therapy

Drug Admini­str­ation

Administer by subcut­aneous injection.
Give once weekly
Monitor site for redness, pain, and swelling after admini­str­ation

Patient Education

Report signs and symptoms of infection immedi­ately.
Avoid immuni­zat­ions, especially those that contain live vaccines
Report skin rashes immedi­ately
Advise clients to report reactions that do not subside within a few days
Report signs and symptoms of heart failure (cough, shortness of breath, elevated blood pressure and heart rate, pink sputum) immedi­ately
Report shortness of breath or new production of sputum


Active infection
Hemato­logic disease


Autoimmune diseases
Live Vaccines
Heart failure


Admini­str­ation with chemot­her­apeutic drugs may cause bone marrow suppre­ssion
Should not be given with anakinra (Kineret) due to increased risk of infections
Live Vaccines


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