Conventional DMARDS
It is the Mode of Action for conventional DMARDS
What is "interferes with critical pathways in the inflammatory cascade to suppress inflammation"?
This is the mode of action and uses for monoclonal antibodies.
What are immunoglobins that are modified to suppress a specific part of the immune system that are used to treat immune diseases, reverse drug effects, and treat cancer.
This is the mode of action for the two types of cytokine inhibitors
What are TNF-alpha–blocking agents, used for rheumatoid arthritis and Crohn’s disease, block the cytokine TNF-alpha and interleukin-blocking agents, used for multiple autoimmune disorders, block the cytokine interleukin?
This is the mechanism of action and the uses for JK inhibitors
What is blocks the JAK enzyme to inhibit cytokine action and is used for steroid refractory acute GVHD, polycythemia vera?
This is the mode of action and uses for conventional antirejection drugs.
What are fungal metabolites that suppress immune cells and widely used for transplant therapy and to prevent graft rejection?
This is the mode of action and uses of cytotoxic immunosuppressive agents.
What is damages or kills dividing cells such as lymphocytes and used to prevent organ rejection, provide immunosuppression?
The first list are the common adverse reactions to conventional DMARDS. The second group is serious adverse reactions.
What are nausea/vomiting, abdominal pain, diarrhea, and rash, and then what are bone marrow suppression and hepatotoxicity?
These common adverse effects usually occur in the first hour following the injection
What are diarrhea, dizziness, fever, chills, malaise, headache, muscle or joint pain, nausea, and vomiting?
These are common adverse reactions to interleukin blockers.
What are headache, injection site reactions (redness, bruising, inflammation, pain), infection, nausea, diarrhea, decreased WBC, sinusitis, and flulike symptoms?
These are the adverse reactions of janus kinase inhibitors
What are dizziness, headache, fatigue, and insomnia, anemia, thrombocytopenia, and neutropenia, increased serum cholesterol, and hypertriglyceridemia?
These are the adverse effects of conventional antirejection drugs.
What are hirsutism, nephrotoxicity, gingival hypertrophy, hypertension, and hyperlipidemia?
These are common adverse reactions from cytotoxic immunosuppressive agents
What are nausea, vomiting, and diarrhea?
These conditions are contraindications to conventional DMARDS
What are active infections, bone marrow suppression, leukopenia, pregnancy, and liver disease?
This is the black box warning for ATG, a polyclonal antibody
What is high risk of anaphylactic reaction to horse serum?
These are two risks of cytokine inhibitors
What are opportunistic infections and aggravation of heart failure?
This must be eliminated during therapy because it increases the effect of roxolitinib. The effects last over 48 hours.
What is grapefruit juice?
This is a black box warning for conventional antirejection drugs.
What is a black box warning for hypertension and nephrotoxicity?
This is the black box warning for cytotoxic immunosuppressants.
What is causes fetal loss and malformation?
These medications increase the effects of conventional DMARDS
What are proton pump inhibitors, NSAIDs, sulfasalazine, and amoxicillin?
This is the reason that drug interactions for monoclonal antibodies are uncommon.
What is monoclonal antibodies do not use the CYP450 metabolic pathway and do not interact with small molecule medications?
This is the use and side effects of Adalimumab (Humira)
What is used for severe rheumatoid arthritis and has side effects of injection site reactions, upper respiratory tract infections, headache, nausea, and skin rash.
These drugs interact with janus kinase inhibitors
What are other immunosuppressants and corticosteroids?
These are drug interactions for conventional antirejection agents.
What are other antirejection agents should not be given concurrently and St. John’s Wort decreases effectiveness?
These are drug interactions for cytotoxic immunosuppressants
What are acyclovir, ganciclovir, probenecid, salicylates increase effects; antacids and cholestyramine that decrease absorption; and herbal preparations that stimulate immune function and decrease effectiveness
These are nursing considerations for conventional DMARDS
What is teach meticulous oral care; teach contraception for both male and female clients; advise of black box warnings; and close monitoring of effect, adverse effect and labs?
These are nursing considerations for monoclonal antibodies and polyclonal antibodies
What are teach the risks of superinfections/opportunistic infections; advise contraception to avoid pregnancy; and teach client to avoid live vaccines?
These are screenings and lab tests done for Tocilizumab (Actemra), a medication used in children for severe rheumatoid arthritis.
What are tuberculosis screening prior to treatment and monitoring of lipid levels and liver enzymes every 3 months?
These are nursing considerations for janus kinase inhibitors.
What are monitor CBC every 2-4 weeks, advise not to use with pregnancy or breast feeding, dosage will be reduced for kidney or hepatic impairment - monitor, and advise client that onset takes up to 11 days for effect?
These are nursing considerations for conventional antirejection agents.
What is monitor serum drug levels, BUN, creatinine, and liver enzymes; signs of serious infection (a concern because immunosuppression is lifelong to avoid graft rejection) and advise that medication may cause low birth weight in newborn.
These are nursing considerations for cytotoxic immunosuppressants
What is assessment of oral intake, elimination pattern, fluid and electrolyte balance, weight changes, rash, bruising, petechiae, and color changes in skin; monitor CBC, kidney function tests, and liver function tests; and teach client to avoid live vaccines.