Home Drug Guide Ustekinumab-aauz

Drug Guide

Generic Name

Ustekinumab-aauz

Brand Names Otulfi

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Interleukin-12 and Interleukin-23 Antagonist

FDA Approved Indications

  • JIA (Juvenile Idiopathic Arthritis) for patients 4 years and older

Mechanism of Action

Ustekinumab-aauz binds to the p40 subunit shared by interleukin-12 and interleukin-23, inhibiting their activity and modulating inflammatory pathways involved in autoimmune disease.

Dosage and Administration

Adult: Not approved for adult use; dosing in pediatric JIA is weight-based, typically administered via subcutaneous injection every 8 weeks after initial dosing.

Pediatric: Dosing varies by weight; typically, initial dose followed by maintenance doses every 8 weeks. Exact dosing should follow prescribing guidelines.

Geriatric: Limited data; caution advised due to immunosuppressive effects.

Renal Impairment: No specific adjustment indicated.

Hepatic Impairment: No specific adjustment indicated.

Pharmacokinetics

Absorption: Subcutaneously absorbed; bioavailability approximately 57%.

Distribution: Distributed primarily in the blood and tissues, specific volume of distribution data limited.

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

Excretion: Excretion pathways not well defined; likely via normal protein degradation processes.

Half Life: Approximately 3 weeks.

Contraindications

  • Hypersensitivity to ustekinumab or any of its components.

Precautions

  • Risk of infection due to immunosuppression; screen for active infections before initiation.
  • Monitor for signs of infection during therapy.
  • Use with caution in patients with a history of malignancy or demyelinating disorders.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Serious infections (e.g., tuberculosis, invasive fungal infections) (Uncommon)
  • Malignancy (e.g., lymphoma) (Rare)
  • Hypersensitivity reactions (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, injection site reactions, and screening for latent tuberculosis before therapy.

Diagnoses:

  • Risk for infection related to immunosuppression.
  • Impaired skin integrity related to injection site reactions.

Implementation: Administer subcutaneously as prescribed; educate patient on infection prevention.

Evaluation: Assess for therapeutic efficacy and adverse effects throughout treatment.

Patient/Family Teaching

  • Report any signs of infection or unusual symptoms.
  • Maintain good hygiene and avoid contact with sick individuals.
  • Inform about possible injection site reactions and how to manage them.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis and invasive fungal infections, have been reported.

Genetic Factors: No specific genetic testing recommended.

Lab Test Interference: Can affect immune function tests; interpret with caution.

Overdose Management

Signs/Symptoms: Unusual or severe side effects, increased risk of infection.

Treatment: Supportive care; no specific antidote. Immediate medical attention recommended.

Storage and Handling

Storage: Store in a refrigerator (36°F to 46°F / 2°C to 8°C).

Stability: Stable until the expiration date; do not freeze. If needed, can be kept at room temperature for a limited time as specified by the package insert.

🛡️ 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.