Home Drug Guide Adalimumab-fkjp

Drug Guide

Generic Name

Adalimumab-fkjp

Brand Names Hulio

Classification

Therapeutic: Immunosuppressant, Anti-TNF alpha agent

Pharmacological: Monoclonal antibody

FDA Approved Indications

  • Juvenile idiopathic arthritis (including polyarticular and systemic forms)
  • Rheumatoid arthritis
  • Crohn's disease (moderate to severe)
  • Ulcerative colitis
  • Plaque psoriasis
  • Hidradenitis suppurativa
  • Ankylosing spondylitis
  • Psoriatic arthritis

Mechanism of Action

Adalimumab binds specifically to tumor necrosis factor-alpha (TNF-alpha), a pro-inflammatory cytokine, thereby inhibiting its interaction with p55 and p75 cell surface TNF receptors. This reduces inflammation and immune response involved in autoimmune diseases.

Dosage and Administration

Adult: Dose varies by condition; for rheumatoid arthritis, typically 40 mg subcutaneously every other week. Adjustments may be needed based on clinical response.

Pediatric: Dosing based on weight and condition; specific protocols provided by FDA or prescribing guidelines.

Geriatric: Use with caution; monitor for infections, adjust if renal/hepatic impairment present.

Renal Impairment: No specific adjustment, but caution advised.

Hepatic Impairment: No specific adjustment, monitor closely.

Pharmacokinetics

Absorption: Subcutaneous administration with peak serum concentrations typically reached in 131 hours.

Distribution: Distributed mainly within the vascular and extravascular spaces; volume of distribution approximately 7.5 L.

Metabolism: Proteolytic degradation into small peptides and amino acids; minor hepatic involvement.

Excretion: Primarily via catabolism; no specific renal excretion data.

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

Contraindications

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

Precautions

  • Screen for latent TB before initiation.
  • SScreen for hepatitis B virus prior to treatment.
  • Monitor for infections during therapy.
  • Use with caution in patients with demyelinating diseases, heart failure, or a history of cancer.

Adverse Reactions - Common

  • Injection site reactions (redness, rash, pain) (Common)
  • Respiratory infections (nasopharyngitis, cough) (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Serious infections (bacterial, viral, fungal) (Less common)
  • Lupus-like syndrome (Rare)
  • Encephalitis, demyelinating diseases (Rare)
  • Lymphoma and other malignancies (Rare, but increased risk noted)

Drug-Drug Interactions

  • Other immunosuppressants (e.g., abatacept, anakinra)
  • Live vaccines (risk of vaccine-related infection)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, TB reactivation, allergic reactions, and signs of malignancy.

Diagnoses:

  • Risk for infection
  • Imbalanced nutrition: less than body requirements due to illness

Implementation: Administer subcutaneous injections as prescribed, monitor for adverse effects, educate patient on infection signs and periodic screening.

Evaluation: Evaluate disease activity and adverse effects periodically, adjust therapy as needed.

Patient/Family Teaching

  • Report signs of infection immediately.
  • Do not receive live vaccines during therapy.
  • Follow infusion and injection schedules precisely.
  • Maintain good hygiene and regular medical follow-up.

Special Considerations

Black Box Warnings:

  • Increased risk of serious infections, including tuberculosis and invasive fungal infections.
  • Risk of lymphoma and other malignancies.

Genetic Factors: No specific genetic markers required for dosing, but genetic factors may influence infection risk.

Lab Test Interference: May interfere with immune response assessments, including screening tests.

Overdose Management

Signs/Symptoms: Unusual injection site reactions, hypersensitivity, general symptoms of infections.

Treatment: Supportive care; no specific antidote. Monitor closely, provide symptomatic relief, and treat infections aggressively.

Storage and Handling

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

Stability: Stable until the expiration date when stored properly. Allow to reach room temperature before injection if 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.