Biologic+Response+Modifying+&+Antirheumatoid+Drugs

Biologic Response – Modifying and Antirheumatoid Drugs

**Biological Response Modifiers Background** Biological Response Modifiers increase the body's response to infection. These chemicals are produced in small amounts naturally in the body, but can be produced in large amounts in a lab and then be used to treat cancer, arthritis, and other diseases. These Immune Stimulants help the immune system fight prolonged infections and specific pathogens that the immune system can not destroy on it's own. Biological Response Modifiers currently in use include interferons, interleukins, monoclonal antibodies, and different types of colony stimulating factors. Side Effects of Biological Response Modifiers include flu-like symptoms such as chills, fever, muscle aches, weakness, loss of appetite, nausea vomiting and diarrhea. Some patients experience bleeding or bruising easily and swelling.

 **Interferons** are secreted by cells that have been infected by a virus. They prevent viral replication and suppress tumor growth.
 * __Interferon Alfa-2b__. Treats chronic hepatitis B and C, AIDS related Kaposi sarcoma, malignant melanoma, and hairy cell leukemia. Mechanism of Action: prevents virus particles from replicating inside the cell, stimulates non-invaded cells to produce antiviral proteins, inhibits tumor growth, and enhances inflammatory response. Side Effects are related to the stimulation of the immune response (flu-like symptoms). Other side effects include bone marrow suppression, depression and suicidal ideation, and liver impairment. Contraindicated in pregnancy and lactation.

 **Interleukins** are secreted by active leukocytes to send messages to other leukocytes. They initiate an immune response, produce more T cells, and increase the activity of B cells, cytotoxic cells, and natural killer cells.
 * __Interleukin__. Treats metastatic renal cell carcinoma in adults and metastatic melanomas. Mechanism of Action: communicate between lymphocytes, stimulates immune response, and inhibits tumor growth. Side effects are attributed to their effect on the body during inflammation. Side effects can include flu-like symptoms, mental status changes, tachycardia, bone marrow suppression, and hypersensitivity (difficulty breathing and chest tightness). Contraindicated in pregnancy and lactation.



**Rheumatoid arthritis**

**Rheumatoid arthritis** is a long term disease that leads to inflammation of the joints and surrounding tissues **Causes:** I**ncidences:** **Risk Factors:** **Signs and Symptoms:**
 * The true cause is unknown but infectious agents such as viruses, bacteria, and fungi have been long suspected; but not proven. Infection itself, genes, and hormones may contribute to the disease as well. Environmental factors such as smoking is currently being researched further to see it's contributing factor to this disease.
 * Believed the tendency to develop RA may be hereditary.
 * Rare but can sometimes start in other parts of the body including the lungs or eyes.
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Sex- women are more affected than men
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Age- though it can occur at any age, it is most common between the ages of 40 and 60
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Family history- because you inherit a predisposition to RA you have have an increased risk
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Smoking- increases your risk
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Usually affects joints on both sides of the body equally. The most common areas include the wrists, fingers, knees, feet, and ankles. The first signs and symptoms seen mimic many other illnesses; these are: fatigue, loss of appetite, low grade fever, swollen glands, and weakness. When the disease later develops, joint pain appears as well as morning stiffness that occurs for more than an hour. The joint may feel warm, tender, and stiff when not used; and can feel "boggy" or "spongy" to the touch. Over time there will be a loss of range of motion and the joint may become deformed in appearance.


 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Name of Drug || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Indication of Use || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Side Effects || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Adverse Effects || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Special Considerations ||
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">__Auronofin (Ridaura)__

<span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Gold – 29% <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">**Antirheumatoid** || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Rheumatoid Arthritis <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Given PO ||  || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Necrotizing enterocolitis, pulmonary fibrosis, exfolliative dermatitis, bone marrow aplasia || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Contraindicated in pregnancy <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">3-6 months of therapy required before effective ||
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">__Aurothioglocose__

<span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Gold – 50% <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">**Antirheumatoid** || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Rheumatoid Arthritis <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Given IM ||  || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Same as above || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Requires monitoring of lab results <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">3-6 months of therapy required before effective <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Contraindicated in pregnancy || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Alters immune response <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">**Antirheumatoid** || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Rheumatoid Arthritis || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Diarrhea, respiratory tract infections, alopecia, rash || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Elevated liver function tests || <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">Patients are immune compromised while on this drug. ||
 * <span style="color: #6500ff; font-family: Arial,Helvetica,sans-serif; font-size: 130%; line-height: normal; margin-bottom: 0.0001pt;">__Leflunomide (Arava)__

<span style="color: #000000; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 270%; text-align: center;">TEST YOURSELF <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;">media type="custom" key="9207048"

<span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;">References: <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> Peteges, N. (2011) Pharmacology. Aurora University. Aurora, IL.

<span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> Karch, A. (2008). Focus on Nursing Pharmacology <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> (5th ed.). Philadelphia: Lippincott Williams & <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> Wilkens.

<span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> Lilleu, L., Harrington, S., Snyder J. (2007). <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> //Pharmacology and the Nursing Process// (5th ed.). <span style="color: #8800ff; font-family: Arial,Helvetica,sans-serif;"> St. Louis MO: Mosby Elseiver.