Home Drug Guide Adalimumab-adbm

Drug Guide

Generic Name

Adalimumab-adbm

Brand Names Cyltezo

Classification

Therapeutic: Immunosuppressant, TNF inhibitor

Pharmacological: Monoclonal antibody (recombinant DNA origin)

FDA Approved Indications

  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Crohn's disease
  • Ulcerative colitis
  • Plaque psoriasis
  • Hidradenitis suppurativa
  • Juvenile idiopathic arthritis
  • Ankylosing spondylitis

Mechanism of Action

Adalimumab is a recombinant monoclonal antibody that binds specifically to tumor necrosis factor-alpha (TNF-α), a pro-inflammatory cytokine, thereby inhibiting its activity and reducing inflammation.

Dosage and Administration

Adult: Varies depending on condition; typical starting dose for rheumatoid arthritis is 40 mg subcutaneously every other week.

Pediatric: Dosing varies; consult specific guidelines for pediatric use.

Geriatric: Adjust as necessary based on tolerability and response; no specific dosage adjustments solely based on age.

Renal Impairment: No specific adjustment recommended.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Subcutaneous administration leads to slow absorption with peak levels typically in 131 hours.

Distribution: Wide distribution including inflamed tissues, low volume of distribution.

Metabolism: Metabolized via proteolytic degradation; not CYP450 involved.

Excretion: Eliminated primarily via proteolytic catabolism; no significant renal excretion.

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

Contraindications

  • Hypersensitivity to adalimumab or its components

Precautions

  • Risk of infections, including tuberculosis; screening recommended before initiation.
  • Use with caution in patients with demyelinating diseases, heart failure, and during pregnancy; consult current guidelines.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Sepsis or severe infections (Less common)
  • Demyelinating disease (Rare)
  • Liver damage or hepatitis B reactivation (Rare)
  • Lymphoma or other malignancies (Rare)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Screen for infections before administering. Monitor for signs of infection, hypersensitivity, and injection site reactions.

Diagnoses:

  • Risk for infection
  • Impaired skin integrity

Implementation: Inject subcutaneously as prescribed. Educate patient on injection technique and side effects.

Evaluation: Assess for improvement in condition and adverse effects; monitor injection sites and infection signs.

Patient/Family Teaching

  • Report any signs of infection promptly.
  • Do not administer live vaccines during treatment.
  • Be aware of potential side effects and when to seek medical attention.
  • Follow proper injection technique and storage instructions.

Special Considerations

Black Box Warnings:

  • Increased risk of serious infections and malignancies, including lymphoma.

Genetic Factors: N/A

Lab Test Interference: May cause false-positive test results for tuberculosis or other infections.

Overdose Management

Signs/Symptoms: Increased risk of infection, injection site reactions.

Treatment: Supportive care; no specific antidote. Discontinue drug and manage symptoms.

Storage and Handling

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

Stability: Stable until the expiration date provided on the packaging when stored properly.

🛡️ 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.