Pharmacologic: interleukin antagonists monoclonal antibodies
Treatment of adults with moderate-to-severe plaque psoriasis who are candidates for phototherapy or systemic therapy.
Binds to the p40 protein subunit used by both the interleukin-12 (IL-12) and IL-23 cytokines. These cytokines that are involved in inflammatory and immune responses, including natural killer cell activation and CD4+ T-cell differentiation and activation. Binding to interleukins antagonizes their effects, disrupting IL-12– and IL-23–mediated signaling and cytokine cascades. Therapeutic Effects: ↓ in area and severity of psoriatic lesions.
Adverse Reactions/Side Effects
CNS: fatigue, headache. Local: erythema. Misc: INFECTION, REVERSIBLE POSTERIOR LEUKOENCEPHALOPATHY SYNDROME.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Be alert for signs of reversible posterior leukoencephalopathy. Signs include headache, confusion, memory lapses, decreased cognition, vision loss, and seizures. Report these signs to the physician immediately.
Watch for signs of infection, including fever, sore throat, chills, nausea, vomiting, diarrhea, and localized inflammation. Notify physician immediately.
Periodically assess skin condition to document whether drug therapy is successful in decreasing the size and severity of psoriatic lesions.
Monitor injection site for redness and warmth. Report prolonged or excessive injection-site reactions to the physician.
Instruct patient to guard against infection (frequent hand washing, etc.), and to avoid crowds and contact with persons with contagious diseases.
Instruct patient to report other troublesome side effects, including severe or prolonged headache or fatigue.
Absorption: Well absorbed following SC administration.
Metabolism and Excretion: Broken down by catabolic processes into peptides and amino acids.
Contraindicated in: Active untreated infection.
Use Cautiously in: History of known malignancy or tuberculosis (possibility of reactivation); OB: Use during pregnancy only if potential benefit justifies potential risk to the fetus. Lactation: Use cautiously in nursing women; unknown risks to infant from gastrointestinal/systemic exposure should be weighed against known benefits of breast-feeding. Pedi: Safe and effective use in patients <18 yr not established.
Exercise Extreme Caution in: Chronic infection or history of recurrent infection.
Drug-Drug: May ↓ antibody response to and ↑ risk of adverse reactions from live vaccines; May ↓ desired ...