Home Drug Guide Ustekinumab-kfce

Drug Guide

Generic Name

Ustekinumab-kfce

Brand Names Yesintek

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Interleukin-12 and Interleukin-23 inhibitor

FDA Approved Indications

  • Plaque psoriasis
  • Crohn's disease
  • Ulcerative colitis
  • Psoriatic arthritis

Mechanism of Action

Ustekinumab binds to the p40 subunit of interleukin-12 and interleukin-23, thereby inhibiting their interaction with their receptor, which downregulates inflammatory pathways involved in psoriasis and other autoimmune conditions.

Dosage and Administration

Adult: Initial dose s injections at weeks 0 and 4, then maintenance doses every 12 weeks. Dosing varies based on indication and body weight.

Pediatric: Limited approval; dosing guided by weight and clinician's discretion.

Geriatric: Adjust dose based on efficacy and tolerability; no specific guidelines, but caution due to immune suppression.

Renal Impairment: No specific dose adjustment recommended.

Hepatic Impairment: No specific data; use with caution. monitor closely.

Pharmacokinetics

Absorption: Peak serum concentrations typically occur 1 hour after subcutaneous injection.

Distribution: Distributed mainly in the vascular and extravascular compartments.

Metabolism: Processed by proteolytic catabolism into small peptides and amino acids.

Excretion: Eliminated via catabolic pathways; no clinically significant renal excretion.

Half Life: Approximately 3 weeks.

Contraindications

  • Hypersensitivity to ustekinumab or its components.

Precautions

  • Risk of infections due to immune suppression; screenings for tuberculosis prior to initiation. Monitor for hypersensitivity reactions. Use with caution in patients with a history of malignancy or demyelinating diseases. Consider pregnancy and lactation status; consult current guidelines.

Adverse Reactions - Common

  • Nasopharyngitis (Frequent)
  • Headache (Common)
  • Fatigue (Less common)
  • Injection site reactions (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., tuberculosis, sepsis) (Rare)
  • Malignancies (e.g., lymphoma) (Rare)
  • Hypersensitivity reactions, including anaphylaxis (Rare)

Drug-Drug Interactions

  • Immunosuppressants, other biologics

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, check TB status before therapy, assess for hypersensitivity reactions.

Diagnoses:

  • Risk for infection
  • Impaired immune response

Implementation: Administer as per dosing schedule, educate patient on infection risk, ensure timely monitoring.

Evaluation: Effectiveness of therapy assessed by symptom improvement, monitor for adverse reactions.

Patient/Family Teaching

  • Report signs of infection immediately.
  • Understand the importance of adherence to dosing schedule.
  • Keep follow-up appointments for monitoring.
  • Inform about possible side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • Serious infections, including tuberculosis and invasive fungal infections, can occur.
  • Malignancies have been reported in clinical trials.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Overdose could potentially increase risk of infection or adverse immune reactions.

Treatment: Supportive care; no specific antidote; monitor closely and provide symptomatic treatment as needed.

Storage and Handling

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

Stability: Stable until the expiration date when stored properly. Keep in original packaging until use.

🛡️ 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.