Pharmacological Treatment for Arthritis

MEDICATION

generic and trade name

drug classification

Medication Mechanism of

Action

Common

Side Effects

Pertinent

Nursing Implications

Patient Teaching

Ibuprofen

Generic and Trade Name: Ibuprofen, Advil, Motrin

Drug Classification: Non-steroidal anti-inflammatory drugs (NSAIDs)

Ibuprofen works by blocking the production of certain hormones, such as prostaglandins, which are known to cause inflammation (Katzung & Trevor, 2020). It also reduces pain and fever.

Constipation, diarrhea, gas, heartburn, nausea, stomach pain, and vomiting

· Instruct patients to tell their healthcare provider if they experience any common side effects of Ibuprofen. Inform patients of the importance of monitoring for any signs of bleeding related to taking Ibuprofen (Rosenthal & Burchum, 2021).

· Monitor patients for any adverse reactions.

· Educate patients about the risk of ulcers or bleeding in the stomach or intestines, and advise them to seek medical attention if symptoms of pain, tenderness, or bleeding occur in the stomach.

Methotrexate

Generic and trade Name: Methotrexate, Trexall

Drug Classification: anti-metabolites

Methotrexate blocks an enzyme involved in DNA replication and cell growth, interfering with the reproduction and growth of cells.

Risk of infection, anemia, nausea, vomiting, fatigue, coughing, shortness of breath, loss of appetite, and low white blood cell count.

· Educate patients about potential side effects associated with Methotrexate.

· Monitor patients for adverse reactions and report any signs of infection or other symptoms of unknown cause (Rosenthal & Burchum, 2021).

· Check white blood cell count and advise patients to contact their healthcare provider if they experience any side effects.

Leflunomide

Generic and Trade Name: Arava

Drug Classification: Immunosuppressant

Leflunomide inhibits the enzyme dihydroorotate dehydrogenase, which is needed to produce DNA in rapidly dividing cells (Katzung & Trevor, 2020).

Nausea, diarrhea, headache, abdominal pain, and hair loss

· Monitor patients closely for potential side effects and any signs of infection.

· Instruct patients to report any unexplained fever, rash, sore throat, or other serious adverse events.

· Educate patients to avoid alcohol and discuss contraception.

· Women of childbearing age should use non-hormonal birth control for at least two years after stopping the medication, and men should use a condom.

Hydroxychloroquine

Generic and Trade Name: Plaquenil

Drug Classification: Antimalarial drug

Hydroxychloroquine works by preventing lysosomal enzymes from breaking down heparin, which will prevent the intracellular death of host cells (Katzung & Trevor, 2020).

Headache, nausea, vomiting, loss of appetite, hair loss, blurred vision, and muscle weakness

· Monitor for potential side effects and any signs of infection.

· Educate patients about hydroxychloroquine side effects and inform them of the importance of reporting any changes in eyesight, abnormal bleeding, and anemia.

· Warn patients about potential photosensitivity and advise them to wear sunscreen.

Infliximab

Generic and Trade Name: Remicade

Drug Classification: Monoclonal antibody

Infliximab binds to soluble and membrane-bound tumor necrosis factor-alpha (TNF-alpha) forms. Inhibiting the activity of TNF-alpha helps to reduce inflammation.

Serious infections, headache, rash, nausea, abdominal pain, insomnia, chills, fever, and itching

· Monitor for any potential side effects and signs of infection.

· Provide patient education on the importance of informing healthcare providers if they experience any changes in their vision or unusual bleeding or bruising (Rosenthal & Burchum, 2021).

· Warn patients about the serious risks of this medication and advise them to seek immediate medical care if an infection occurs.

Anakinra

Generic and Trade Name: Kineret

Drug Classification: Interleukin-1 receptor antagonist

Anakinra binds to the same cell membrane receptor as the pro-inflammatory cytokine interleukin-1 (IL-1). This helps to limit the action of IL-1, which will reduce inflammation.

Headache, flu-like symptoms, injection site reactions, joint pain, nausea, and bleeding

· Monitor for potential side effects and any signs of infection.

· Instruct patients to inform the healthcare providers if they experience vision changes, unusual bleeding, or bruising.

· Explain the importance of storing medication properly and avoiding contact with persons with symptoms of infection.

Abatacept

Generic and Trade Name: Orencia

Drug Classification: T-cell co-stimulation modulator

Abatacept modulates the immune system by preventing certain immune system cells from activating.

Headache, upper respiratory infection, rash, injection site reactions, nausea, and diarrhea

· Monitor for potential side effects and any signs of infection (Rosenthal & Burchum, 2021).

· Instruct patients to inform the healthcare provider if they experience vision changes, unusual bleeding, or bruising.

· Explain the importance of storing medication properly and avoiding contact with persons with symptoms of infection.

Rituximab

Generic and Trade Name: Rituxan

Drug Classification: Anti-CD20 monoclonal antibody

Rituximab binds to CD20 found on the surface of B-cells, resulting in cell death and suppression of B-cell activities (Katzung & Trevor, 2020).

Fever, chills, shortness of breath, cough, low blood pressure, and headache

· Monitor for any potential side effects and signs of infection.

· Monitor vital signs and for any signs or symptoms of low blood pressure.

· Provide patient education on the importance of informing healthcare providers if they experience any changes in their vision or unusual bleeding or bruising.

MEDICATION

generic and trade name

drug classification

Medication Mechanism of

Action

Common

Side Effects

Pertinent

Nursing Implications

Patient Teaching

Golimumab

Generic and Trade Name: Simponi

Drug Classification: Tumor Necrosis Factor (TNF) inhibitor

Golimumab is a monoclonal antibody that binds to and inhibits TNF-alpha (Katzung & Trevor, 2020). This helps to reduce inflammation.

Upper respiratory infection, headache, nausea, injection site reactions, cough, and abdominal pain

· Monitor for potential side effects and any signs of infection.

· Instruct patients to inform their healthcare provider if they experience any vision changes, unusual bleeding, or bruising (Rosenthal & Burchum, 2021).

· Warn patients about the serious risks of this medication and advise them to seek immediate medical care if an infection occurs.

Tocilizumab

Generic and Trade Name: Actemra

Drug Classification: Interleukin-6 (IL-6) receptor antagonist

Tocilizumab binds to and blocks Interleukin-6 (IL-6) receptors, inhibiting IL-6 signaling (Katzung & Trevor, 2020). This helps to reduce inflammation and modulate the immune system.

Upper respiratory infection, headache, diarrhea, abdominal pain, and injection site reactions

· Monitor for potential side effects and any signs of infection.

· Instruct patients to inform their healthcare provider if they experience any vision changes, unusual bleeding, or bruising (Rosenthal & Burchum, 2021).

· Warn patients about the serious risks of this medication and advise them to seek immediate medical care if an infection occurs.

References

Katzung, B. G., & Trevor, A. J. (2020). Basic and Clinical Pharmacology 15e. In Google Books. McGraw Hill Professional. https://www.google.co.ke/books/edition/Basic_and_Clinical_Pharmacology_15e/il0EEAAAQBAJ?hl=en

Rosenthal, L. D., & Burchum, Jacqueline. R. (2021). Lehne’s pharmacotherapeutics for Advanced Practice Nurses (2nd ed.). St. Louis, MO: Elsevier.

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Question

Pharmacological Treatment for Arthritis

Purpose of the Assignment

Identify the common pharmacologic treatments for inflammatory diseases of the human body.
Review the potential effects medication has on the clients’ basic care and comfort needs.
Identify nursing interventions meeting the basic care and comfort needs of clients receiving these pharmacological agents.

Course Competencies

Describe strategies for safe, effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious, and inflammatory disorders.
Explain components of multidimensional nursing care for clients with musculoskeletal disorders.
Select appropriate nursing interventions when providing multidimensional care to clients experiencing alterations in mobility.

Instructions

Complete the table directly below these instructions in your own words for each of the following medications: