Home Drug Guide Ustekinumab-auub

Drug Guide

Generic Name

Ustekinumab-auub

Brand Names Wezlana

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Interleukin-12 and Interleukin-23 Antagonist

FDA Approved Indications

  • Plaque Psoriasis
  • Psoriatic Arthritis

Mechanism of Action

Ustekinumab binds to the p40 subunit of interleukin-12 and interleukin-23, preventing their interaction with the IL-12 receptor, thereby modulating the inflammatory pathway involved in psoriasis and psoriatic arthritis.

Dosage and Administration

Adult: Initial dose of 45 mg or 90 mg subcutaneously, depending on weight and condition, administered at weeks 0, 4, then every 12 weeks.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dose adjustments required, but caution due to comorbidities.

Renal Impairment: No specific dose adjustment needed.

Hepatic Impairment: No specific dose adjustment needed.

Pharmacokinetics

Absorption: Subcutaneous administration with peak levels in 1 week.

Distribution: Distributed in vascular and extravascular compartments.

Metabolism: Metabolized via catabolism similar to IgG antibodies.

Excretion: Excreted mainly via proteolytic catabolism.

Half Life: Approximately 3 weeks.

Contraindications

  • Hypersensitivity to ustekinumab or excipients.

Precautions

  • Increased risk of infections, including serious infections. Use with caution in patients with active infections, history of malignancy, or demyelinating disease. Pregnancy category B; weigh benefits and risks.

Adverse Reactions - Common

  • Lower respiratory tract infections (Occasional)
  • Headache (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., pneumonia, cellulitis) (Rare)
  • Malignancies (non-melanoma skin cancer) (Rare)
  • Hypersensitivity reactions including anaphylaxis (Rare)

Drug-Drug Interactions

  • Other immunosuppressants, live vaccines, TNF inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, skin cancers, and neurological symptoms.

Diagnoses:

  • Risk for Infection
  • Impaired Skin Integrity

Implementation: Administer as prescribed, observe for adverse reactions, educate patient on infection signs.

Evaluation: Evaluate skin health, infection frequency, and patient's response to therapy.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Avoid live vaccines during therapy.
  • Use sunscreen and skin protection to monitor for skin malignancies.
  • Follow injection instructions carefully.

Special Considerations

Black Box Warnings:

  • Serious infections and malignancy

Genetic Factors: None specified.

Lab Test Interference: May affect tuberculin skin test reactivity.

Overdose Management

Signs/Symptoms: Unknown, but potential for exaggerated immunosuppressive effects.

Treatment: Supportive care; no specific antidote.

Storage and Handling

Storage: Store in a refrigerator (36°F to 46°F / 2°C to 8°C). Do not freeze.

Stability: Stable until the expiration date on the package when stored properly.

🛡️ 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.