Rituximab Injection: A Case Study

Danisha Stewart April 18, 2012 Research Article Critique 1 NURS 4922 1. Brodaty, H., Ames, D., Snowdon, J., Woodward, M., Kirwan, J., Clarnette, R., & ... Greenspan, D. (2005). Risperidone for psychosis of Alzheimer's disease and mixed dementia: results of a double-blind, placebo-controlled trial. International Journal of Geriatric Psychiatry, 20(12), 1153-1157.

More than one third of the patients do not respond to induction therapy (primary nonresponse) and even among initial responders, the response wanes over time. John Berg has been treating Jeffery Monroe with Adalimumab for his IBD. She had begun to exhibit symptoms / or loss of response that may be attributed to subtherapeutic levels of Adalimumab (ADA) and/or the presence of antibodies to

Encephalitis is a neurological disorder that results in the inflammation of the brain and sometimes the meninges. It is usually due to a viral infection. Most often arboviruses cause encephalitis, by transference via mosquitos to humans and animals. When bitten by an infected mosquito the virus moves from the mosquito into the person’s blood, it then reaches the brain and spinal cord, it multiplies within the central nervous system thus inflaming and damaging nerve cells, this interferes with signals from the brain to the rest of the body. The herpes simplex virus type one can commonly cause encephalitis. HIV has also been noted as an increasing cause of encephalitis. Viral infections like: mumps, chicken pox and measles can also cause encephalitis, but rarely.

The immaturity of the data is underscored by the disposition at the time of analysis. Patients were more likely to have discontinued based on adverse events than to have had disease progress or be continuing therapy. Although tolerability looked better when only patients receiving tremelimumab 1 mg were analyzed, even in that group, 30% of patients had a related grade > 3 adverse event, with 16% of patients discontinuing due to an adverse event and 4% dying from the study therapy. For comparison, in the studies that led to approval of pembrolizumab and nivolumab, grade > 3 related adverse events were seen in 7-10.5%, adverse events led to discontinuation of study therapy in 0.2-3.8% and death was related to study treatment in 0-0.3%.2, 3, 4

Epstein Barr virus (EBV) he explained to me is a type of herpes virus that causes infectious mononucleosis and can also be associated with different cancers. EBV attacks the cells that line the mouth and throat. The virus can affect the lungs, liver, bone marrow and eyes. It is often confused with Chronic Fatigue Syndrome. To me, this sounded like a better prognosis than lymphoma. The doctor explained that there was no treatment for the virus; I should continue my healthy lifestyle. He cautioned me that I would need to watch the swollen lymph nodes and have them checked regularly. I promised that I

ENCEPHALITIS Encephalitis literally means an inflammation of the brain, but it usually refers to brain inflammation caused by a virus. It may also be called “acute viral encephalitis or aseptic encephalitis';. Encephalitis is an infectious disease of the Central Nervous System characterized by pathologic changes in both the gray and white matter of the spinal cord and brain. It may be due to specific disease entity such as rabies or an arthropod-borne virus (arbovirus), or it may occur as a sequela of influenza, measles, German measles, chicken pox, herpes virus infection, small pox, vaccinia, or other diseases. The specific viruses involved may vary. Exposure can also occur through insect bites, food or drink, or skin

Jann States that sufferers of BPD are three times more likely to suffer a depressive episode than a manic or hypomanic episode. (Jann, 2014) The Joanna Briggs institute Identified that the suicide rate for bipolar suffers are 15 times higher than that of non-affected individuals of the same age and sex. Eighty percent of these suicides occur during a depressive episode. (Hung Chu, 2016). Therefore appropriate pharmacological therapy not only during the maintenance period to reduce reoccurrence but also during these acute episodes is highly important. Pharmaceutical treatment includes the use of medication such as mood stabilizers, anti-psychotics and anti-depressants. The Joanna Briggs institute recommends that combination therapy involving both mood stabilizers such as Sodium valproate or lithium valproate and antipsychotics risperidone, olanzapine, quetiapine and haloperidol is best to treat acute mania associated with Bipolar. As it increases adherence to medication regime. (Tufanaru, 2016) The same institute encourages the use Olanzapine as a monotherapy or in combination with fluoxetine in the treatment of Depression associated with Bipolar disorder. (Hung chu, 2016) Lithium continues to be the first line mood stabilizer under current guidelines but may be used in conjunction with Carbamazepine where depression is evident. (Hung chu, 2016) The Australian and New Zealand Journal of Psychiatry 2015 also shows preference for combination therapy

Abstract Risperidone has been utilized as an atypical antipsychotic and prescribed since 1994. It is mainly used for treatment in those with schizophrenia, bipolar disorder, attention deficit hyperactivity disorder, and irritability in autism spectrum disorder. Risperidone has multiple types of administration and the most common is oral tablet form. This can

Evaluate the superiority of brodalumab to ustekinumab by comparing reductions in PASI 100 scores from week 0 to week 12 of treatment.

After one month and six months of treatment, the disease severity decreased from 6.9 ± 4.1 and 6.6 ± 5.0 respectively. 25% percent of the patients experienced an increase in the level of serum creatinine but this was brought back to normal after 6 months when a decrease in the dose of CsA was implemented after the first month. On the overall, CsA MEPC is a reliable way of reducing the severity of the range of symptoms present with MG. However, the scientists involved in this particular research article did mention that sample size was relatively small and that some differences could be present between ethnic populations concerning the efficacy of CsA. Rituximab is a genetically modified anti-CD20 monoclonal antibody which attaches with high affinity to cells displaying CD20 and induces the depletion of B-lymphocytes. The research study performed by Illa et al. required the use of 6 patients with severe MG, 3 patients with MuSK +MG and 3 with

The trial involved four different treatment levels, and patients were encouraged to enter the next level of treatment if they failed to achieve remission or response (50% reduction in symptoms) after a specified number of

There are only treatments to suppress symptoms, treat complications related to the disease, and relieve discomfort (Harvery and Zieve). The treatments to suppress symptoms include the use of topical creams to treat skin rash. The topical creams used for the treatment of lupus contain corticosteroids to suppress inflammation and immune activity. The use of corticosteroids is essential to suppresses inflammation and immune response. Corticosteroids work by suppressing T cell secretions of cytokines, and suppressing B cells ability to bind with interleukins (Harvery and Zieve; Simanta, and Mohan). Corticosteroids diminish neutrophils adhesion, chemotaxis, phagocytosis, and secretion of toxic substance (Harvery and Zieve; Simanta, and Mohan). Corticosteroids also reduce the production of prostaglandins and leukotrienes (Harvery and Zieve; Simanta, and Mohan). A more mild treatment method is the use of nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs block prostaglandins, therefore, suppressing blood vessel dilation, inflammation, and pain (Harvery and Zieve). On more aggressive cases of SLE the use of immunosuppressant drugs is required. These drugs impedes the production of immune cells. In 2011, the first biological drug made specificly for the treatment of lupus was approved by the Food and Drug Administration (FDA) (Harvery and Zieve). This drug is called Belimumab. It targets B cells that have lost self-tolerance (Harvery and Zieve; Smcconnell). Because the causes of lupus are not yet well known, there are no prevention

People with the disease may exhibit irritability, anxiety, and depression in the early stages. In later stages they may exhibit agitation, anger, aggression, hallucinations, restlessness, verbal or physical outburst, and delusions. Medications given are antidepressants such as; citalopram, fluoxetine, paroxeine, sertraline and trazodone. For anxiety, restlessness and verbal behavior anxiolytics are given such as; lorazepam and oxazepam. Antipsychotics that may be given are; aripiprazole, clozapine, haloperidol, olanzapine, quetiapine, risperidone and ziprasidone. The use of antipsychotics should be seriously weighed for the risk of stroke and

The serotonin and norepinephrine reuptake inhibitors, SNRIs include duloxetine (Cymbalta), desvenlafaxine (Pristiq), levomilnacipran (Fetzima), and venlafaxine (Effexor) are used as first-line agents and are administered

Encephalitis Encephalitis is a condition caused by viruses which cause the brain to become inflamed. There are two types of encephalitis one is called primary because the viruses affect the brain itself. Secondary is the viruses travel from some other part of the body that has been affect to the brain. When the virus reaches the brain it begins to multiply causing inflammation. The brain’s white matter can be destroyed. This destruction causes cell death, hemorrhage and edema. The edema begins to compress the blood vessels this causes intracranial pressure (Mayo Clinic, 2011).