Home Drug Guide Adalimumab-aacf

Drug Guide

Generic Name

Adalimumab-aacf

Brand Names Idacio

Classification

Therapeutic: Immunosuppressant, Anti-inflammatory

Pharmacological: TNF-alpha inhibitor

FDA Approved Indications

  • Rheumatoid arthritis
  • Polyarticular juvenile idiopathic arthritis
  • Ankylosing spondylitis
  • Crohn's disease
  • Ulcerative colitis
  • Plaque psoriasis
  • Hidradenitis suppurativa
  • Juvenile idiopathic arthritis (JIA)
  • Ankylosing spondylitis

Mechanism of Action

Adalimumab-aacf is a monoclonal antibody that binds to tumor necrosis factor-alpha (TNF-α), thereby inhibiting its interaction with p55 and p75 cell surface TNF receptors. This reduces inflammatory responses in autoimmune diseases.

Dosage and Administration

Adult: Dosed based on condition; typically 40 mg subcutaneously every other week. Adjustments depend on response and tolerability.

Pediatric: Dosing varies; typically weight-based. For example, for pediatric Crohn's disease, 20 mg or 40 mg every other week.

Geriatric: No specific dosage adjustment; use with caution due to potential increased risk of infections.

Renal Impairment: No specific adjustment recommended.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Subcutaneous administration: peak levels in 5 days

Distribution: Widely distributed in tissues, limited crossing of blood-brain barrier

Metabolism: Metabolized via standard protein degradation pathways

Excretion: Eliminated via catabolism to peptides and amino acids

Half Life: Approximately 2 weeks (range 10-20 days)

Contraindications

  • Hypersensitivity to adalimumab or its components
  • Active infections, including tuberculosis

Precautions

  • Screen for latent TB before initiation.
  • Use with caution in patients with a history of demyelinating disease, infections, or heart failure.
  • Monitor for signs of infection during therapy.
  • Pregnancy category B; discontinue if pregnancy occurs. Lactation consider risk-benefit.

Adverse Reactions - Common

  • Injection site reactions (Common)
  • Infections (upper respiratory, urinary tract) (Common)

Adverse Reactions - Serious

  • Serious infections (including sepsis, TB reactivation) (Less common)
  • Hypersensitivity reactions (Rare)
  • Hematologic reactions (cytoplasmia) (Rare)
  • Lupus-like syndrome (Very rare)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, injection site reactions, and allergic responses. Baseline TB screening required.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Administer as prescribed, monitor response and adverse effects, ensure proper storage.

Evaluation: Assess for reduction in disease symptoms, monitor for adverse events.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Notify provider of any allergic reactions.
  • Do not administer live vaccines during therapy.
  • Follow injection technique instructions carefully.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis and opportunistic infections
  • Malignancies, including lymphoma and other cancers

Genetic Factors: Genetic variations may influence response or risk of adverse effects.

Lab Test Interference: May interfere with immune system markers; routine labs should be monitored.

Overdose Management

Signs/Symptoms: No specific overdose symptoms identified, but excessive immunosuppression may increase infection risk.

Treatment: Supportive care; no specific antidote. Discontinue drug and monitor patient closely.

Storage and Handling

Storage: Refrigerate at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable for up to 14 days at room temperature in the original carton, if necessary, but best stored refrigerated.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.