MONOCLONAL ANTIBODIES

Jodie Evans
Mind Map by Jodie Evans, updated more than 1 year ago
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Mindmap on Monoclonal Antibodies as they relate to the treatment of breast cancer and RA

Resource summary

MONOCLONAL ANTIBODIES
1 DUAL AGENTS
1.1 Chronic Inflammatory Disease
1.1.1 Remicade (Infliximab)
1.1.1.1 Pharmacological Class & Indications
1.1.1.1.1 Class
1.1.1.1.1.1 Biologic Agents
1.1.1.1.2 Indications
1.1.1.1.2.1 Tumor necrosis factor (TNF) inhibitors
1.1.1.2 Main Disease State
1.1.1.2.1 Rheumatoid Arthritis
1.1.1.2.1.1 Physiological Concepts
1.1.1.2.1.1.1 Autoimmune disease where the immune system attacks the joints. Joint pain, tenderness, swelling and stiffness for 6 weeks or longer, morning stiffness for 30 minutes or longer, more than 1 joint is affected, the same joints on both sides of the body are affected, fatigue, loss of appetite, and a low-grade fever
1.1.1.2.1.2 Non-Drug Treatments/Lifestyles Modifications
1.1.1.2.1.2.1 Heat & cold therapies, Orthotics & splints, Therapeutic exercise, Healthy eating with an anti-inflammatory diet and plenty of rest
1.1.1.2.1.3 Ongoing Monitoring
1.1.1.2.1.3.1 Periodic labs for Serum C-reactive protein levels, X-rays for progression or remission of disease activity, Reduction of signs & symptoms, TB testing prior to & during treatment and Monitor for skin cancer
1.1.1.3 Alternative Disease States
1.1.1.3.1 Crohn's Disease, Psoriasis, Ankylosing Spondylitis, Psoriatic Arthritis
1.1.1.4 Routes of Administration & Appropriate Populations
1.1.1.4.1 Adults & Geriatrics
1.1.1.4.2 Dosed using body surface area (BSA) or weight-based so doses can vary
1.1.1.4.3 Pediatric & Juvenile - orphan drug designation
1.1.1.4.4 IV Only. Must be infused using 0.9% NS. Not compatible with dextrose
1.1.1.5 Drug & Food Interactions
1.1.1.5.1 Drug Drug Interactions
1.1.1.5.1.1 Anakinra, Tacrolimus, Cyclosporine, Tocilizumab, Paclitaxel, Abatacept, Sirolimus, Warfarin, Quinidine, Rilonacept, Phenytoin, Live Vaccines
1.1.1.5.2 Food Interactions
1.1.1.5.2.1 NONE
1.1.1.6 Black Box Warnings & Adverse Effects
1.1.1.6.1 Black Box Warnings
1.1.1.6.1.1 Increased risk for serious infections including TP, sepsis & fungal infections
1.1.1.6.1.2 Lymphoma & possible other malignancies in children & juveniles
1.1.1.6.2 Adverse Effects
1.1.1.6.2.1 Acute Coronary Syndrome, Cardiorespiratory Arrest, Chest Pain, Heart Failure, Hypertension, Hypotension, Myocarditis, Peripheral Edema, Systemic Vasculitis
1.2 CANCER
1.2.1 Herceptin (Trastuzumab)
1.2.1.1 Main Disease State
1.2.1.1.1 Breast Cancer
1.2.1.1.1.1 Physiological Concepts
1.2.1.1.1.1.1 Breast lump, Abnormal mammograms, Visual or feel changes in the breast, Blood-stained or clear fluid discharge from nipple
1.2.1.1.1.2 Non-Drug Treatments/Lifestyle Modifications
1.2.1.1.1.2.1 Seek emotional support, Eat healthy, Reduce stress, Limit or eliminate alcohol consumption, Exercise regularly, Maintain healthy weight
1.2.1.1.1.3 Ongoing Monitoring
1.2.1.1.1.3.1 During Treatment: Labs & Cardiac assessments; Post Treatment: Regular health screening, Vitamin D levels checked regularly & Continue mammograms
1.2.1.2 Alternative Disease States
1.2.1.2.1 Gastric Cancer, Stomach Cancer & Pancreatic Cancer (Off label/Orphan)
1.2.1.3 Pharmacological Class & Indications
1.2.1.3.1 Class
1.2.1.3.1.1 Biologic Agents
1.2.1.3.2 Indications
1.2.1.3.2.1 Human epidermal growth factor receptor (HER2) inhibitor
1.2.1.4 Drug & Food Interactions
1.2.1.4.1 Drug Drug Interactions
1.2.1.4.1.1 Warfarin, Dexamethasone, Tamoxifen, Vitamin D3 & Zofran
1.2.1.4.2 Food Interactions
1.2.1.4.2.1 Grapefruit
1.2.1.5 Routes of Administration & Appropriate Populations
1.2.1.5.1 IV Only. Must be infused using 0.9% NS. Not compatible with dextrose.
1.2.1.5.2 Adults & Geriatric Only
1.2.1.5.3 Dosed using body surface area (BSA) or weight-based so doses can vary
1.2.1.6 Black Box Warnings & Adverse Effects
1.2.1.6.1 Black Box Warnings
1.2.1.6.1.1 Cardiomyopathy - more common when used in conjunction with other cytotoxic agents
1.2.1.6.1.2 Fatal Infusion Reactions & Pulmonary Toxicity - usually seen within 24 hours of infusion
1.2.1.6.1.3 Embryo-Fetal Toxicity - Should not be used during pregnancy
1.2.1.6.2 Adverse Effects
1.2.1.6.2.1 Heart Failure, Edema, Tachycardia, Rash, Abdominal Pain, Diarrhea, Loss of Appetite, Nausea, Vomiting, Anemia, Backache, Headache, Dizziness, Insomnia, Cough, Neutropenia, Thrombosis
2 AKA MABs
2.1 Additional MABS
2.1.1 Avastin/Bevacizumab
2.1.1.1 Rituxan/Rituximab
2.1.1.1.1 Stelara/Ustekinumab
2.1.1.1.1.1 Adcetris/Brentuximab
2.1.1.1.1.1.1 Erbitux/Cetuximab
2.1.1.1.1.1.1.1 Yervoy/Ipilimumab
2.1.1.1.1.1.1.1.1 Vectibix/Panitumumab
2.1.1.1.1.1.1.1.1.1 Cyramza/Ramucirumab
2.1.1.1.1.1.1.1.1.1.1 Humira/Adalimumab
2.1.1.1.1.1.1.1.1.1.1.1 Cimzia/Certolizumab pegol
2.1.1.1.1.1.1.1.1.1.1.1.1 Simponi/Golimumab
2.1.1.1.1.1.1.1.1.1.1.1.1.1 Opdivio/Nivolumab
2.1.1.1.1.1.1.1.1.1.1.1.1.1.1 Vectibix/Panitumumab
2.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1 Keytruda/Pembrolizumab
2.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1 Actemra/Tocilizumab
2.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1.1 Kadcyla/Ado-Trastuzumab Emtansine
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