Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
TNF alpha is a protein that the body produces during when there is
inflammation, the body's reaction to injury. TNF alpha promotes inflammation and
its associated fever and signs (pain, tenderness, and swelling) in several
inflammatory conditions including rheumatoid arthritis and ankylosing
spondylitis. Etanercept is a synthetic (man-made) protein that binds to TNF
alpha. It thereby acts like a sponge to remove most of the TNF alpha from the
joints and blood. This prevents TNF alpha from promoting inflammation and the
fever, pain, tenderness, and swelling of joints in patients with rheumatoid or
psoriatic arthritis and ankylosing spondylitis. Etanercept prevents the
progressive destruction of the joints in patients with rheumatoid arthritis and
the arthritis of psoriasis. The FDA approved etanercept in November 1998.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: 25 mg multiple use vial; 25 or 50 mg prefilled syringe; 50 mg
prefilled autoinjector.
STORAGE: Sterile powder and pre-filled syringes should be refrigerated at
2-8 C (36-46 F). Reconstituted solutions made from the powder should be used as
soon as possible but may be stored in the vial at 2-8 C (36-46 F) for 14 days.
PRESCRIBED FOR: Etanercept is used as primary treatment to reduce the pain,
swelling, and tenderness of joints resulting from moderate to severe rheumatoid
arthritis in adults. It also may be used when rheumatoid arthritis has not
adequately responded to other drugs (called disease-modifying drugs for
rheumatoid arthritis). For example, etanercept can be used in combination with
methotrexate (Rheumatrex,
Trexall) in patients who do not respond adequately to methotrexate alone.
Etanercept also is used to reduce the signs and symptoms of moderately to
severely active, polyarticular-course,
juvenile rheumatoid arthritis in children
who have had an inadequate response to one or more disease-modifying drugs.
Etanercept is approved for the treatment of ankylosing spondylitis, psoriatic
arthritis, and plaque psoriasis. It can prevent the progressive destruction of
joints and improve physical function with psoriatic arthritis.
Etanercept is not recommended for persons with preexisting disease of the
central nervous system (brain and/or spinal cord) or for those with
multiple
sclerosis, myelitis, or optic neuritis.
Plaque psoriasis: 50 mg twice weekly for 3 months, followed by 50 mg once
weekly
Juvenile rheumatoid arthritis: 0.8 mg/kg weekly, with a maximum of 50 mg
per week
DRUG INTERACTIONS: Because etanercept may reduce the response of the immune
system, etanercept should not be administered with live vaccines. Combining
etanercept with anakinra (Kineret) or abatacept (Orencia), drugs that also
reduce the response of the immune system may increase the risk of serious
infections.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Kawasaki disease is a rare children's disease characterized by a fever that lasts more than five days and at least four of the following five symptoms are present: rash, swollen neck lymph gland, red tongue, swelling or redness of the hands or feet, and conjunctivitis. High doses of aspirin are used to treat Kawasaki disease. Cortisone and antiinflammatory drugs may also be used during treatment.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
The tuberculosis skin test is a test used to determine if someone has developed an immune response to the bacterium that causes tuberculosis (TB). This response can occur if someone currently has TB, if they were exposed to it in the past, or if they received the BCG vaccine against TB (which is not performed in the U.S.). The World Health Organization estimates that 2 billion people worldwide have latent TB, while around 3 million people worldwide die of TB each year. The tuberculosis skin test is also known as the tuberculin test or PPD test.
The tuberculin skin test is based on the fact that infection with M. tuberculosis
bacterium produces a delayed-type hypersensitivity skin reaction to certain components of the bacterium. The components of the organism are contained in extracts of culture filtrates and are the core elements of the classic tuberculin PPD (also known as purified protein derivative). This PPD mat...
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