CITATION

Summary of an Article from International Journal

Medication Safety Concerns Surrounding
Immunomodulators
Author : Margo S. Farber, PharmD
University of Michigan Health System

US Pharmacist. 2016;41(6):HS2-HS8.

Retreived on :
http://www.medscape.com/viewarticle/870479_print
Friday, December 23th 2016

Summary Arranged by :
Name : Lutvi Anggraeni
NIM : 1012016003
Course : English
Lecturer : Rimbi Budi Setiarini, S.Pd., M.Pd
Date : Friday, December 30th 2016
Undergraduate of Pharmacy
STIKES HARAPAN BANGSA 2016/2017
In the feature article Medication Safety Concerns Surrounding Immunomodulators.
The author Margo S. Farber, PharmD (2016), explains about his review discusses all
immunomodulators; rather, categories of associated adverse events (AEs) and necessary
safeguards when using this drug class will be identified.
The definition of immunomodulators or immunomodulating agents is medication that use to
manage these disorders either suppress or stimulate an element of the immune system
overriding the devastating effects of immune-mediated disease. Generally, immunomodulator
classification into two types there are immunosuppressants and immunostimulants.

Medication Safety, AEs, and the Medication-use Process

Pharmacists must focus on adverse drug reactions as well as medication errors and also can
minimize it by knowing patients medication record about may have a hypersensitivity
reaction prior to drug initiation. Medication errors can preventable by alert in improving the
medication-use process to avoid common medication errors.

Drug Procurement and Storage

Medication errors begins from the purchasing and storage of this complex group of drugs or
Look-alike/sound-alike (LASA) drugs that causing error services in pharmacies. The
preventive strategies for medication errors by recognize known LASA drugs and regularly
updates its list of commonly drug names. From table research 1 in the article further states
that Although most immunomodulators are stable at room temperature, the package labeling
for avoidance of extreme temperature excursions will preserve the product's integrity.

Prescribing

The patients corcern if they receiving immunomodulators, they will receiving the risk of
infection, both primary infection and reactivation of latent infections. Prior to initiation,
patients must be screened for risk factors or historical exposure to the pathogens associated
with these infections. In some circumstances like example prophylaxis, concurrent therapy, or
immunization prior to therapy. But in many cases, evidence-based guidelines are lacking and
the decision to initiate or continue immunomodulator therapy is one of risk versus benefit.
The health-system pharmacist to be acutely aware of the emerging data on infection risk for
the multitude of immunomodulators currently available, the pharmacist should work with
another health-system to assure that a strategy is in place to screen and monitor patients for
potential infection risk. Looking at the expansive AE profile associated with the
immunomodulator class, so it is important to measure pertinent baseline laboratory
parameters prior to drug initiation. From table research 2 in the article, Farber states that
several immunomodulators are teratogenic with pregnancy.
One of simple safeguard for prescribing is to discourage the use of abbreviations for
preventing medication errors. Pharmacists should identify drug-interaction screening to make
sure appropriate safety alerts for medication-safety when immunomodulators are being used.

Dispensing

pharmacists should careful review about prescribing-safety prior to dispensing of

immunomodulators and careful handling to avoid occupational risk to healthcare
professionals and to maintain product integrity.

Administration

Patients and nursing staff should be educated on methods to minimize injection-site reactions
which critically important to enhance patient adherence. And also they should corcern to
safety of infusion-associated reactions (IARs) to immunomodulators administered IV.
Medications to manage reactions should be readily available, along with guidelines or
algorithms for management. Premedication with antihistamines, antipyretics, antiemetics,
and/or analgesics may be indicated depending on the medication and the patient's history.

Monitoring

Monitoring The patients safety is aiming for minimizing side effects. Lifelong users of
immunomodulator therapy are at particular risk for infections, secondary malignancies,
nephrotoxicity, hepatotoxicity, and impaired glycemic control.

Conclusion

Farber concludes that the immunomodulator has risks and rewards to patients with
devastating chronic illness. Pharmacist has important role in ensuring that these medications
are used safely and effectively by appropriate drug selection for medication, monitoring the
patients safety during medication, and alert about laboratory assessments.
References

Margo S. Farber, PharmD. 2016. Medication Safety Concerns Surrounding

Immunomodulators. US Pharmacist 41 (6) : HS2-HS8.
http://www.medscape.com/viewarticle/870479_print (Accessed 2016-12-23)