Large Molecule Pharmacotherapy: Biologics in Clinical Nurse Specialist Practice.

Abstract

Few scientists acquainted with the chemistry of biological systems at the molecular level can avoid being inspired. The development of biologics for the past 20 years has changed the treatment paths for cancer and autoimmune disorders across the life span. Rather than beginningwith the disease, biotechnology-based care begins with the identification of genetic variation and uses cell-based therapies to modify the variation. Biologics are directed to specific genotypes or protein receptors. Some of the targets for biologic therapies include anemia, cystic fibrosis, diabetes, hemophilia, hepatitis, genital warts, transplant rejection, cancers, and tissue reconstitution for wounds. Biologic development is not a new science. Human growth hormone, insulin, and red blood cellYstimulating agents have been on the market for decades. However, with the deepening understanding of genetics and disease, there has been significant expansion in the development of genomics, proteomics, microarray, cell cultures, and monoclonal antibody technologies. The increasing number of biologic development platforms across the pharmacy industry worldwide suggests that this pharmacotherapy will bring even more options for therapy options for the future. There is no simple definition for biologics. A strict definition of biologics would include only agents produced by living systems consisting of large molecules containing hundreds of amino acids. Another definition would describe a biologic as any substance composed of organic molecules no matter the size. Still, others would include products created in other organisms such estrogen hormone from pregnant mare urine. Finally, biologic can be defined as a product created by a microorganism or mammalian cell, which are large complex molecules, most of which are proteins or polypeptides. Biologics are described as large complexmolecules such as a virus, toxin, antitoxin, therapeutic serum, vaccine, blood productor component, or trivalent organic arsenic compound used for the prevention, treatment, or cure of a disease. The complex molecules and/or mixture are not easily labeled because of construction from bacteria, yeast, insects, plants, other purified natural sources, or mammalian cells. The Table describes the most commonly prescribed biologics, based on these broad definitions. Also included is the biologic type, approval date, Web site address for specific information for use and prescribing, and indications for use.