BRM's (Biological Response Modifiers) used for RA

serious infection TB MS

Contraindicated in which patients?

Rituximab

Drug has a BLACK BOX WARNING about serious infections

Tocilizumab

May cause decrease in WBCs, platelets and liver dysfunction

Anakinra

May cause severe decrease in WBC count

Abatacept

Monitor for dyspnea, wheezing, Flushing, and itching

Rituximab

Observe for infusion reaction as for entanercept

Infliximab

Only BRM that shouldn't be refrigerated

Infliximab

Patient is to report chest pain or difficulty breathing during infusion, and monitor bp

Abatacept

Patient is to report cough, dizziness and sore throat; not to receive love vaccines while taking this drug

Anakinra

Patient is to report respiratory symptoms such as cough and fever; malignancies can result

Golimumab

Patient is to report s/s of infection, including fever and malaise; should avoid live vaccines while taking this drug

Crowds Live vaccines Ppl with infections

What patients should avoid when taking BRMs?

Golimumab

Adverse effects include HTN, GI distress and infection

Etanercept (Enbrel) Infliximab Adalimunab Anakinra

After administration, monitor site for reaction