Home Drug Guide Ustekinumab-srlf

Drug Guide

Generic Name

Ustekinumab-srlf

Brand Names Imuldosa

Classification

Therapeutic: Immunosuppressant, Monoclonal Antibody

Pharmacological: Interleukin-12 and Interleukin-23 Antagonist

FDA Approved Indications

  • Plaque Psoriasis (Adults)
  • Crohn’s Disease (Adults and Pediatrics)
  • Ulcerative Colitis (Adults)
  • Active Psoriatic Arthritis

Mechanism of Action

Ustekinumab binds to the p40 subunit of interleukin-12 and interleukin-23, inhibiting their interaction with the IL-12R and IL-23R, thus modulating the inflammatory pathways involved in autoimmune conditions.

Dosage and Administration

Adult: Administer subcutaneously, initial dose at 45 mg or 90 mg depending on the condition, followed by maintenance doses every 12 weeks.

Pediatric: Dosing varies based on weight and condition; specific pediatric dosing guidelines should be consulted.

Geriatric: No specific adjustment required, but monitor for infections.

Renal Impairment: No specific adjustment, caution advised.

Hepatic Impairment: No specific adjustment indicated.

Pharmacokinetics

Absorption: Bioavailability approximately 57% after subcutaneous administration.

Distribution: Highly bound to plasma proteins.

Metabolism: Degraded into small peptides and amino acids through catabolic pathways.

Excretion: Excreted via normal protein catabolic pathways.

Half Life: Approximately 3 weeks (21 days).

Contraindications

  • Hypersensitivity to ustekinumab or excipients.

Precautions

  • Risk of infection; contraindicated in active infections.
  • Screen for tuberculosis before initiation.
  • Potential for hypersensitivity reactions; monitor after administration.
  • Use with caution in patients with a history of malignancy.

Adverse Reactions - Common

  • Nasopharyngitis (Common)
  • Headache (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Serious infections (e.g., TB, fungal infections) (Uncommon)
  • Malignancies (e.g., lymphoma) (Rare)
  • Hypersensitivity reactions including anaphylaxis (Rare)

Drug-Drug Interactions

  • No significant direct interactions reported.

Drug-Food Interactions

  • No specific food interactions.

Drug-Herb Interactions

  • Limited data, caution advised with herbal supplements.

Nursing Implications

Assessment: Monitor for signs of infection (fever, malaise), assess for allergy or hypersensitivity reactions.

Diagnoses:

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

Implementation: Administer as per prescribed schedule. Educate patient on infection prevention.

Evaluation: Evaluate for effectiveness of therapy, monitor for adverse reactions, especially infections.

Patient/Family Teaching

  • Report any signs of infection immediately.
  • Not to receive live vaccines while on therapy.
  • Follow injection administration instructions carefully.
  • Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings:

  • Serious infection and Malignancy risk.

Genetic Factors: None specified.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Potential for increased risk of infections or hypersensitivity reactions.

Treatment: Supportive care; no specific antidote. Discontinue therapy and provide symptomatic treatment as needed.

Storage and Handling

Storage: Refrigerate at 2°C to 8°C (36°F to 46°F). Protect from light.

Stability: Stable until the expiration date 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.