idursulfase
idursulfase
(i-dur-sul-fase) idursulfase,Elaprase
(trade name)Classification
Therapeutic: replacement enzymePharmacologic: enzymes
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
IV | rapid | end of infusion | unknown |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- headache (most frequent)
- malaise
Cardiovascular
- hypertension
Gastrointestinal
- dyspepsia
Dermatologic
- cutaneous reactions (most frequent)
Local
- infusion site swelling
Musculoskeletal
- arthralgia (most frequent)
Miscellaneous
- anaphylaxis (life-threatening)
- fever (most frequent)
Interactions
Drug-Drug interaction
None noted.Route/Dosage
Availability
Nursing implications
Nursing assessment
- Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing) during and for 24 hrs after infusion. Keep epinephrine, an antihistamine, corticosteroids, and resuscitation equipment close by in case of anaphylactic reaction.
- Monitor for infusion-related reactions (headache, fever, rash, pruritus, erythema, urticaria, hypertension. Most reactions are managed with antihistamines and/or corticosteroids prior to or during infusions, slowing rate of infusion, and/or early discontinuation if reaction is serious.
Potential Nursing Diagnoses
Impaired physical mobility (Indications)Implementation
- Patients with compromised respiratory function or acute respiratory disease are at increased risk of life-threatening infusion reactions. Consider delaying infusion in patients with concomitant acute respiratory and/or febrile illness.
- Intermittent Infusion: Determine number of vials required for the dose ordered. If number of vials includes a fraction, round up to next whole number. Vials are for single use; discard remaining medication. Dilute each vial in 100 mL of 0.9% NaCl. Use an infusion set with a 0.2 micrometer filter for administration. Mix gently; do not shake solution. Solution is clear to slightly opalescent; do not administer solutions that are discolored or contain particulate matter. Solution may be stored in refrigerator for up to 48 hr. Discard solution of not administered or refrigerated within 8 hrs.
- Rate: Administer at 8 mL/hr for first 15 min. If well tolerated, may increase by 8 mL/hr at 15 min intervals to administer total volume within desired time. Do not exceed 100 mL/hr. May slow, temporarily stop, or discontinue for that visit if infusion reactions occur. Administer total infusion over 1–3 hrs. May require longer times if infusion reactions occur; should not exceed 8 hrs.
- Y-Site Incompatibility: Do not administer other medications or solutions in same tubing as idursulfase.
Patient/Family Teaching
- Explain purpose of infusion to patient and parents.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Inform patient that a Hunter Outcome Survey was established to evaluate long term treatments. For information, visit www.elaprase.com or call 1–866–888–0660.
Evaluation/Desired Outcomes
- Improved walking capacity in patients with Hunter syndrome.