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disease modifying antirheumatic drugs
Medication Names
Prototye Med |
etenercept (Enbrel) |
Other Meds |
infliximab (Remicade) |
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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 |
Pharyngitis |
Psoriasis |
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 |
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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 |
Contraindications
Active infection |
Hematologic disease |
Malignancy |
Precautions
Autoimmune diseases |
Live Vaccines |
Heart failure |
Interactions
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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