Home Drug Guide Infliximab-dyyb

Drug Guide

Generic Name

Infliximab-dyyb

Brand Names Inflectra, Zymfentra

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: TNF-alpha inhibitor

FDA Approved Indications

  • Crohn's disease
  • Ulcerative colitis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Plaque psoriasis

Mechanism of Action

Infliximab-dyyb binds to tumor necrosis factor-alpha (TNF-alpha), a pro-inflammatory cytokine, preventing it from interacting with its receptors, thereby reducing inflammation and immune response.

Dosage and Administration

Adult: Dose varies by indication; typically 3 mg/kg IV infusion at weeks 0, 2, 6, then every 8 weeks

Pediatric: Dosing varies; consult specific guidelines for age-dependent dosing

Geriatric: Use with caution; consider renal, hepatic, and cardiac comorbidities

Renal Impairment: Adjustments not typically necessary, but monitor closely

Hepatic Impairment: Use with caution; no specific dosage adjustments

Pharmacokinetics

Absorption: Not applicable (administered IV)

Distribution: Widely distributed in body fluids and tissues

Metabolism: Metabolized via catabolism into smaller peptides and amino acids

Excretion: Eliminated via proteolytic degradation pathways

Half Life: Approximately 7-10 days varies by patient and condition

Contraindications

  • Hypersensitivity to infliximab or excipients
  • Active infection, including tuberculosis

Precautions

  • Screen for latent TB before initiation
  • Risk of serious infections, malignancies, demyelinating disease, heart failure, and hepatotoxicity

Adverse Reactions - Common

  • Infusion site reactions (Common)
  • Infections, including respiratory and urinary tract infections (Common)
  • Headache, nausea (Common)

Adverse Reactions - Serious

  • Serious infections, including sepsis and opportunistic infections (Uncommon to rare)
  • Malignancies, including lymphoma (Rare)
  • Demyelinating disease (Rare)
  • Hepatosplenic T-cell lymphoma (Very rare, primarily in young males with Crohn's or ulcerative colitis)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines, certain biologics

Drug-Food Interactions

  • None specifically identified

Drug-Herb Interactions

  • Limited data; caution advised with herbal supplements affecting immune response

Nursing Implications

Assessment: Monitor for signs of infection, allergic reactions, and infusion reactions; baseline TB screening required.

Diagnoses:

  • Risk for Infection
  • Impaired Skin Integrity

Implementation: Administer via IV infusion with appropriate premedication if necessary; monitor vital signs during and after infusion.

Evaluation: Assess for adverse reactions; monitor disease activity; ensure patient education regarding infection risk.

Patient/Family Teaching

  • Report signs of infection (fever, chills, cough), infusion reactions, or allergic responses.
  • Keep all follow-up appointments for infusions and monitoring.
  • Inform about the importance of TB screening before therapy.

Special Considerations

Black Box Warnings:

  • Serious infections leading to hospitalization or death.
  • Malignancies, including lymphoma and other cancers.
  • Hepatosplenic T-cell lymphoma (rare).

Genetic Factors: Certain genetic predispositions may influence immune response; genetic testing not routine.

Lab Test Interference: May interfere with certain laboratory assays; always inform lab personnel when ordering tests.

Overdose Management

Signs/Symptoms: Unusual infusion reactions or symptoms of infection.

Treatment: Supportive care; no specific antidote—manage symptoms; discontinue infliximab-dyyb.

Storage and Handling

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

Stability: Stable for up to 24 hours at room temperature for prepared solutions, following specific guidelines.

🛡️ 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.