Home Drug Guide Adalimumab-aqvh

Drug Guide

Generic Name

Adalimumab-aqvh

Brand Names Yusimry

Classification

Therapeutic: Immunosuppressant, TNF inhibitor

Pharmacological: Monoclonal antibody

FDA Approved Indications

  • Crohn's Disease
  • Ulcerative Colitis
  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Ankylosing Spondylitis
  • Plaque Psoriasis
  • Hidradenitis Suppurativa
  • Juvenile Idiopathic Arthritis

Mechanism of Action

Adalimumab is a recombinant IgG1 monoclonal antibody that binds specifically to tumor necrosis factor-alpha (TNF-α), a cytokine involved in systemic inflammation. By inhibiting TNF-α, it reduces inflammation and immune system activity.

Dosage and Administration

Adult: Variable depending on the condition; typically 40 mg subcutaneously every other week.

Pediatric: Dosing varies by age and condition; consult specific prescribing information.

Geriatric: Adjust based on comorbidities and tolerability; no specific dose reduction recommended solely due to age.

Renal Impairment: No specific dosage adjustment required.

Hepatic Impairment: No specific dosage adjustment required.

Pharmacokinetics

Absorption: Subcutaneous absorption with bioavailability approximately 64%.

Distribution: Distributed primarily in the vascular and extravascular compartments.

Metabolism: Metabolized via proteolytic degradation to small peptides and amino acids.

Excretion: Eliminated through proteolytic degradation pathways; not primarily renal.

Half Life: Approximately 2 weeks.

Contraindications

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

Precautions

  • Screen for latent TB before initiation.
  • Monitor for infections during therapy.
  • Assess for heart failure symptoms; use with caution in patients with NYHA Class III/IV.

Adverse Reactions - Common

  • Injection site reactions (Common)
  • Upper respiratory infections (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., sepsis, pneumonia) (Less common)
  • Malignancies (e.g., lymphoma) (Rare)
  • Demyelinating diseases (Rare)
  • Heart failure exacerbation (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, TB screening results, injection site reactions.

Diagnoses:

  • Risk for infection

Implementation: Administer as prescribed, monitor patient response, educate patient on infection risk.

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

Patient/Family Teaching

  • Report signs of infection or unusual symptoms immediately.
  • Do not receive live vaccines during therapy.
  • Understand the importance of adherence to dosing schedule.

Special Considerations

Black Box Warnings:

  • Serious infections including tuberculosis and fungal infections.
  • Malignancies, including lymphoma and other cancers.

Genetic Factors: Limited data on genetic influences on response.

Lab Test Interference: May affect immune markers; interpret results cautiously.

Overdose Management

Signs/Symptoms: Possible severe infections, hypersensitivity reactions.

Treatment: Supportive care, monitor vital signs, ensure airway patency, consult poison control.

Storage and Handling

Storage: Store in a refrigerator (2°C to 8°C). Do not freeze.

Stability: Stable until the expiration date when refrigerated; can be kept at room temperature for up to 14 days.

🛡️ 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.