Match each patient scenario describing the initiation of a specific targeted biologic or immunomodulatory therapy with the most appropriate infectious disease screening or prophylactic management step.
- A 45-year-old man with multiple sclerosis is scheduled to begin induction therapy with alemtuzumab.Prescribe trimethoprim-sulfamethoxazole and acyclovir prophylaxis due to profound, prolonged T-cell and B-cell depletion.
- A 55-year-old woman with severe rheumatoid arthritis is preparing to start therapy with infliximab.Perform an interferon-gamma release assay and obtain a chest radiograph to rule out latent granulomatous infection.
- A 62-year-old man with follicular lymphoma will undergo induction chemoimmunotherapy including rituximab.Screen with hepatitis B surface antigen and core antibody; initiate antiviral prophylaxis if core antibody is positive.
- A 28-year-old woman with paroxysmal nocturnal hemoglobinuria is initiated on eculizumab therapy.Administer quadrivalent and serogroup B meningococcal vaccinations due to terminal complement cascade blockade.
Cevap
Alemtuzumab pairs with TMP-SMX/acyclovir prophylaxis; Infliximab pairs with tuberculosis screening; Rituximab pairs with Hepatitis B screening; Eculizumab pairs with meningococcal vaccination.
Modern immunomodulatory therapies create specific, predictable infectious vulnerabilities based on their molecular targets. Understanding the mechanism of action of each biologic is essential for implementing the correct pre-treatment screening and prophylactic regimens to prevent severe iatrogenic complications.
Adım Adım Çözüm
Anahtar Kavram
Infectious disease screening and prophylaxis protocols for patients initiating specific targeted biologic and immunomodulatory therapies are directly dictated by their mechanisms of immunosuppression.