Home Drug Guide Adalimumab-bwwd

Drug Guide

Generic Name

Adalimumab-bwwd

Brand Names Hadlima

Classification

Therapeutic: Immunosuppressant; TNF inhibitor

Pharmacological: Monoclonal antibody against tumor necrosis factor-alpha (TNF-α)

FDA Approved Indications

  • Crohn's disease
  • Ulcerative colitis
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Plaque psoriasis
  • Juvenile idiopathic arthritis
  • Hidradenitis suppurativa
  • Uveitis
  • Malignancies associated with immunosuppressive therapy

Mechanism of Action

Adalimumab binds specifically to TNF-α, a pro-inflammatory cytokine, neutralizing its activity and thereby reducing inflammation and immune response.

Dosage and Administration

Adult: Dosing varies by indication; typically 40 mg subcutaneously every other week. Dosage adjustments may be necessary based on individual response and tolerability.

Pediatric: Dosing depends on weight and condition; specific pediatric dosing guidelines should be followed.

Geriatric: No specific dosage modifications, but age-related factors should be considered.

Renal Impairment: No specific adjustments required.

Hepatic Impairment: No specific data; use with caution.

Pharmacokinetics

Absorption: Subcutaneous absorption is slow and incomplete; peak serum concentrations occur approximately 4-8 days after injection.

Distribution: Distributed mainly within the vascular and interstitial spaces.

Metabolism: Metabolized via proteolytic pathways into small peptides and amino acids.

Excretion: Primarily degraded in the reticuloendothelial system; not renally excreted.

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

Contraindications

  • Hypersensitivity to adalimumab or any excipients.
  • Active infections, including tuberculosis.

Precautions

  • Screen for latent TB before initiating therapy.
  • Caution in patients with demyelinating diseases, heart failure, or risk of malignancy. Monitor for infections and other adverse events.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Serious infections (e.g., tuberculosis, bacterial sepsis) (Serious)
  • Lymphoma or other malignancies (Serious)
  • Demyelinating diseases (Serious)
  • Severe allergic reactions (anaphylaxis) (Serious)

Drug-Drug Interactions

  • Other biologics, immunosuppressants, live vaccines

Drug-Food Interactions

  • None specifically noted

Drug-Herb Interactions

  • Caution with herbal supplements that may affect immune function.

Nursing Implications

Assessment: Monitor for signs of infection, neurological symptoms, and hypersensitivity reactions. Assess for tuberculosis prior to therapy.

Diagnoses:

  • Risk for infection related to immunosuppression
  • Risk for tissue injury due to allergic or adverse reactions

Implementation: Administer subcutaneously as prescribed. Educate patient to report signs of infection or adverse effects.

Evaluation: Evaluate treatment efficacy (reduction in symptoms). Monitor for adverse reactions.

Patient/Family Teaching

  • Advise to report signs of infection immediately.
  • Instruct on proper injection technique.
  • Warn about increased risk of infections and malignancies.
  • Inform about possible side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis, and malignancies, including lymphoma.

Genetic Factors: None specific.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Possible increased risk of infection or adverse reactions.

Treatment: Supportive care; no specific antidote. Monitor vital signs and symptoms. Discontinue drug and provide appropriate therapy.

Storage and Handling

Storage: Store in refrigerator at 2°C to 8°C (36°F to 46°F); do not freeze.

Stability: Stable until the expiration date printed on the package when stored properly. Protect from light.

🛡️ 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.