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Rituximab

Red-tux-mob
Picmonic
Rituximab is a monoclonal antibody medication targeting CD20, a protein expressed on B-cells. For this reason, this medication is effective in treating disorders of B-cell malignancy, dysfunction or excess. Side effects of using this medication include infusion reactions at the site of IV administration, and the development of skin and oral reactions. Rituximab is associated with reactivation of hepatitis B virus, along with the development of progressive multifocal leukoencephalopathy.
11 KEY FACTS
INDICATIONS
Chronic Lymphocytic Leukemia (CLL)
CaLL me Crone

Rituximab destroys both normal and malignant B cells that have CD20 on their surfaces, and can be used for lymphomas and leukemias. Rituximab is indicated in treating previously untreated and previously treated CD20-positive CLL. Typically, it is combined with fludarabine and cyclophosphamide.

Non-Hodgkin Lymphoma
Nun-hog-king with Lime-foam

Rituximab destroys both normal and malignant B cells that have CD20 on their surfaces, and can be used for lymphomas and leukemias. This medication is indicated for treating previously untreated, stable, and refractory cases of non-Hodgkin lymphoma (NHL).

Rheumatoid Arthritis
Roman King-Arthur

Rituximab, when used in combination with methotrexate, is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response to one or more TNF-inhibitor therapies.

Microscopic Polyangiitis (MPA)
Microscope Polly-angel

Rituximab is combined with glucocorticoids to treat microscopic polyangiitis (MPA), a small vessel vasculitis.

Wegener's (Granulomatosis with Polyangiitis)
Wagoneers

Rituximab is indicated for the treatment of adult patients with Granulomatosis with Polyangiitis (GPA) (formerly Wegener's Granulomatosis), and is used in combination with glucocorticoids.

MECHANISM
Monoclonal Antibody Against CD20
Monocle Ant-tie-body with CD (20) Dollar-bill

Rituximab is a monoclonal antibody to CD20. This means that it is derived from identical immune cells that are all clones of a unique parent cell, producing a specific antibody to the CD20 protein, which is expressed on B-cells.

Found on B Cell Neoplasms
Basket-balls

CD20 is widely expressed on B-cells, and Rituximab binds as an antibody to these CD20 proteins. Once bound, a conformational change occurs, making these "tagged" B-cells easily identifiable by natural killer (NK) cells.

SIDE EFFECTS
Infusion Reactions
In-fused-IV Reaction

During IV administration, or within 24 hours, patients may develop infusion reactions, which are characterized by hives, rash, itching, facial or oral swelling, sudden cough, shortness of breath, difficulty breathing and chest pain.

Skin and Mouth Reactions
Skin-suit and Mouth Reactions

Patients can develop severe skin and mouth-related reactions. Symptoms can include painful sores, ulcers, or skin blisters with lip or mouth involvement, peeling skin, rash, or pustules.

Reactivation of Hepatitis B Virus (HBV)
Happy-tie-liver Bee

Patients who have had hepatitis B or are carriers of hepatitis B virus may develop a reactivation infection from rituximab. Patients should not take this medication if they have active HBV liver disease, as reactivation may lead to worsening liver disease or death. Patients taking this drug should have diagnostic blood work done prior to administration, and should be followed for several months after rituximab is initiated by their provider.

Progressive Multifocal Leukoencephalopathy (PML)
PML-brain

There is also an association between rituximab administration and the development of progressive multifocal leukoencephalopathy (PML). This is a rare, serious brain infection that can lead to severe disability and death. Symptoms can include difficulty thinking, loss of balance, changes in speech or walking, weakness on one side of the body, or blurred or lost vision.

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