somatropin rDNA
somatropin rDNA (injection)
(soe-ma-troe-pin),Valtropin
(trade name)Classification
Therapeutic: hormonesPharmacologic: growth hormones
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (blood levels)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
SC | unknown | 4 hr | 24 hr |
Contraindications/Precautions
Adverse Reactions/Side Effects
Central nervous system
- intracranial hypertension
Cardiovascular
- edema of hands and feet (↑ in adults)
Endocrinologic
- hyperglycemia
- ↓ insulin insensitivity
- rapid growth
Interactions
Drug-Drug interaction
Excessive corticosteroid use (equivalent to 10–15 mg/m2/day) may ↓ response to growth hormone.May induce CYP450 enzymes and may ↓ effectiveness of drugs metabolized by CYP450.Oral estrogen may ↑ dose requirements.Route/Dosage
Availability
Nursing implications
Nursing assessment
- Monitor bone age annually and growth rate determinations, height, and weight every 3–6 mo during therapy.
- Assess patients with Turner syndrome for otitis media and other ear disorders; may have increased risk of ear and hearing disorders.
- Monitor for any malignant transformation of skin lesions.
- Lab Test Considerations: May cause ↑ serum levels of inorganic phosphorus, alkaline phosphatase, parathyroid hormone (PTH) and IGF-I during somatropin therapy.
- Monitor blood glucose periodically during therapy. Diabetic patients may require ↑ insulin dose.
Potential Nursing Diagnoses
Disturbed body image (Indications)Implementation
- Subcutaneous: Reconstitute with 1.5 mL of diluent provided or Sterile Water for Injection. Dilute by aiming the liquid against glass vial wall. Do not shake; swirl gently to dissolve. Solution is clear; do not use solutions that are cloudy or contain a precipitate. Discard unused solution diluted with water. Solutions diluted with diluent stable for 21 days; do not freeze. Thighs are preferred injection site. Rotate injection sites with each dose.
Patient/Family Teaching
- Instruct patient and parents on correct procedure for reconstituting medication, site selection, technique for subcut injection, and disposal of needles and syringes. Review dose schedule. Parents should report persistent pain or edema at injection site.
- Explain rationale for prohibition of use for increasing athletic performance. Administration to persons without growth hormone deficiency or after epiphyseal closure may result in acromegaly (coarsening of facial features; enlarged hands, feet, and internal organs; increased blood glucose; hypertension).
- Advise parents to monitor blood glucose closely in children with diabetes mellitus.
- Emphasize need for regular follow-up with endocrinologist to ensure appropriate growth rate, to evaluate lab work, and to determine bone age by x-ray exam.
Evaluation/Desired Outcomes
- Child’s attainment of adult height in growth failure secondary to pituitary growth hormone deficiency. Therapy is limited to period before closure of epiphyseal plates (approximately up to 14–15 yr in girls, 15–16 yr in boys).
- Replacement of growth hormone in deficient adults.