Choose a pharmacological agent that has been on the market less than 5 years (Janus kinase (JAK) inhibitors) and discuss the following.
- Drug Class
- Mechanism of Action
- Drug Administration and Dosage
- Drug Interactions
- Lab effects/interference
- Nursing Management
- Patient Education Considerations (special considerations)- provide examples specific to client age needs- geriatric, pediatric and pregnant client
- Patient Assessment
- Side Effects/Adverse Effects/Toxicities
- Special considerations- provide examples specific to client age needs- geriatric, pediatric, and pregnant clients
Drug Class: Janus kinase (JAK) inhibitors
Mechanism of Action: These inhibitors target JAK enzymes, particularly JAK1, JAK2, JAK3, or TYK2, involved in cytokine signaling pathways. By blocking these enzymes, they modulate the immune response, reducing inflammation seen in autoimmune conditions like rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
Drug Administration and Dosage: The administration and dosage of JAK inhibitors, such as upadacitinib (Rinvoq) or filgotinib (Jyseleca), vary based on the specific condition being treated. Typically, they are oral medications taken once daily. Dosages are adjusted depending on the patient’s condition, prior treatment history, and response.
Drug Interactions: JAK inhibitors may interact with other medications metabolized through similar pathways or affecting the immune system. For instance, co-administration with immunosuppressants or medications that affect liver enzymes might require dosage adjustments or careful monitoring due to potential interactions.
Lab Effects/Interference: JAK inhibitors might cause changes in laboratory parameters, including alterations in liver function tests, lipid profiles, and blood cell counts. Regular monitoring of these parameters is essential to detect any abnormalities early on during treatment.
Patient Education Considerations:
Nursing Management:
Nurses should monitor patients regularly for adverse effects and disease activity.
Educate patients on the importance of adherence to treatment plans and regular follow-ups.
Patient Education Considerations (special considerations):
Geriatric Patients: Educate elderly patients about potential side effects like an increased risk of infections or changes in blood cell counts. Emphasize the need for close monitoring and prompt reporting of any unusual symptoms.
Pediatric Patients: Provide age-appropriate education to pediatric patients and caregivers about medication usage and potential adverse effects. Discuss growth and development concerns with the pediatrician.
Pregnant Clients: JAK inhibitors are generally not recommended during pregnancy due to potential risks to the fetus. Discuss the risks and benefits with pregnant patients, and if needed, collaborate with specialists to explore alternative treatments.
Patient Assessment: Assessing patients before and during treatment involves monitoring disease activity, assessing for signs of infections, liver function, lipid profiles, and blood cell counts.
Side Effects/Adverse Effects/Toxicities: Potential side effects may include an increased risk of infections, gastrointestinal issues, liver function abnormalities, changes in lipid profiles, and alterations in blood cell counts. Additionally, there are concerns about potential cardiovascular risks.
Special Considerations for Different Client Ages:
Geriatric Patients: Monitor for increased susceptibility to infections and potential changes in blood cell counts or liver function.
Pediatric Patients: Emphasize the importance of monitoring growth, development, and any signs of infections.
Pregnant Clients: Discuss potential risks and alternative treatments due to the possible adverse effects on fetal development.
Always consult healthcare professionals and refer to the most recent prescribing information and guidelines for specific dosages, precautions, and considerations based on patient demographics and conditions.