Common Tumor Necrosis Factor (TNF) Blockers

Question 1

Common Tumor Necrosis

Factor (TNF) Blockers Drug Names

Answer 1

Adalimumab
Etanercept
Infliximab

Question 2

Common Tumor Necrosis

Factor (TNF) Blockers Therapeutic Actions

Answer 2

• Act to decrease the local effects of TNF, a locally released cytokine that can cause the death of tumor cells and stimulate a wide range of proinflammatory activities

Question 3

Common Tumor Necrosis

Factor (TNF) Blockers Indications

Answer 3

• Often the first class used with progressing arthritis

Question 4

Common Tumor Necrosis

Factor (TNF) Blockers Contraindications and Cautions

Answer 4

Contraindications:
•	Acute infection,
•	Cancer
•	Sepsis
•	Tuberculosis
•	Hepatitis
•	Myelosuppression or demyelinating disorders 

Caution:
• Pregnancy and lactation
• Hepatic and renal disorders

Question 5

Common Tumor Necrosis

Factor (TNF) Blockers DDI

Answer 5

DDI:

• Immune suppressant drugs and live vaccines

Question 6

Common Tumor Necrosis

Factor (TNF) Blockers Adverse Effects

Answer 6

• Black box warnings about the risk of serious to fatal infections and the development of lymphomas and other cancers

Question 7

Common Tumor Necrosis
Factor (TNF) Blockers:
Assessment

Answer 7

Assess:
Hx: allergy, any signs of infection,
Physical: vital signs, skin, temp, CNS status, cancer screening, monitor ROM, movement, and pain levels, respirations and adventitious sounds (baseline)
Labs: monitor

Question 8

Common Tumor Necrosis
Factor (TNF) Blockers:
Diagnosis

Answer 8

Dx:

• Acute pain: to CNS disease process
• Risk for infection related to drug therapy
• Anxiety related to disease process and drug effects
• Deficient knowledge: drug therapy

Question 9

Common Tumor Necrosis
Factor (TNF) Blockers:
Implementation

Answer 9

Implementation:
• Teach patient proper preparation, administration of subcutaneous injections
• Monitor for immune suppression reaction and CNS toxicity
• Arrange for continuation of nondrug therapies to deal with arthritis
• Ensure patient has routine cancer screening and regular follow-up
• Provide thorough patient teaching

Question 10

Common Tumor Necrosis
Factor (TNF) Blockers:
Evaluation

Answer 10

Eval:
Response to the drug 
Adverse effects 
Effectiveness of comfort measures Compliance with the regimen
Effectiveness of the teaching plan