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Name /bks_53161_deglins_md_disk/c1inhibitor 02/21/2014 08:17AM Plate # 0-Composite pg 1 # 1 Interactions Drug-Drug: None noted. 1 C1 inhibitor (human) (See-one in-hib-i-tor) PDF Page #1 Route/Dosage Cinryze Classification Therapeutic: antiangioedema agents Pharmacologic: proteinase inhibitors Pregnancy Category C IV (Adults and adolescents): 1000 units every 3 or 4 days. NURSING IMPLICATIONS Assessment ● Assess for signs (facial or abdominal swelling, pain, nausea, vomiting, cramps, di- arrhea) and frequency of HAE. ● Assess for signs and symptoms of hypersensitivity reactions (hives, urti- Indications Routine prophylaxis against angioedema attacks in adult and adolescent patients with Hereditary Angioedema (HAE). Action Replaces C1 inhibitor which is deficient in patients with HAE. C1 inhibitor is necessary in preventing the chain of events which alter vascular permability resulting in life-threatening swelling in patients with HAE. Therapeutic Effects: Decreased frequency, intensity and duration of HAE attacks. Implementation IV Administration ● Intermittent Infusion: Diluent: Reconstitute each of 2 vials with 5 mL of Ster- TIME/ACTION PROFILE ROUTE ONSET PEAK DURATION IV within 1 hr 12 hr 3–4 days Contraindications/Precautions Contraindicated in: Life-threatening immediate hypersensitivity reactions. Use Cautiously in: Patients with known risk of thrombotic events; OB, Lactation: Use during pregnancy only if clearly needed; use cautiously during lactation; Pedi: Safety not established. Adverse Reactions/Side Effects CNS: headache. CV: THROMBOEMBOLIC EVENTS. Derm: rash. Misc: Hypersensitivity ⫽ Canadian drug name. ⫽ Genetic Implication. Potential Nursing Diagnoses Ineffective airway clearance (Indications) Pharmacokinetics Absorption: IV administration results in complete bioavailibility. Distribution: Unknown. Metabolism and Excretion: Unknown. Half-life: Single dose— 56 hr. reactions including ANAPHYLAXIS. caria, tightness of the chest, wheezing, hypotension, anaphylaxis) during or after injection. Symptoms may be similar to HAE attacks; consider treatment methods carefully. If hypersensitivity occurs, discontinue infusion treat symptomatically. Epinephrine should be immediately available for treatment of acute severe hypersensitivity reaction. ● Monitor patients with known risk factors for thrombotic events. ile Water for Injection by removing the protective covering from one end of the double-ended transfer needle and inserting exposed needle through the center of the diluent vial stopper. Remove protective covering from the other end of the double-ended transfer needle. Invert diluent vial over the upright and slightly angled C1 inhibitor vial; then rapidly insert the free end of the needle through the center of the C1 inhibitor vial stopper. Vaccuum in the vial will draw in the diluent. Do not use if there is no vacuum in the vial. Disconnect the two vials by removing the needle from the C1 inhibitor vial stopper and discard the diluent vial, along with the transfer needle directly into the sharps container. Gently swirl C1 inhibitor vial until all powder is completely dissolved. Solution is colorless to slightly blue; do not administer solutions that are discolored, turbid, or contain a precipitate. Insert the filter needle into the vial of reconstituted solution. Inject air into the vial and withdraw the reconstituted C1 inhibitor into the syringe. Repeat with a second CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued. Name /bks_53161_deglins_md_disk/c1inhibitor 02/21/2014 08:17AM Plate # 0-Composite pg 2 # 2 2 PDF Page #2 vial to make complete dose. Concentration: 100 units/mL. Discard partially used vials. Attach a suitable needle or infusion set with winged adapter, and inject intravenously. Administer at room temperature within 3 hr of reconstitution. Do not freeze; protect solution from light. Rate: Administer at an initial infusion rate 1 mL/min over 10 min. If tolerated, continue same as the maintenance infusion rate. ● Y-Site Incompatibility: Do not mix with other materials. Patient/Family Teaching ● Inform patient that C1 inhibitor is made from human plasma and may contain in- fectious agents that can cause disease. ● Instruct patient to notify health care professional immediately if signs and symptoms of allergic hypersensitivity reactions or thrombosis (new onset swelling and pain in limbs or abdomen, new onset chest pain, shortness of breath, loss of sensation or motor power, altered consciousness or speech) occur. ● Advise female patients to notify if health care professional if pregnancy is planned or suspected or if breast feeding. Evaluation/Desired Outcomes ● Decreased frequency, intensity and duration of HAE attacks. Why was this drug prescribed for your patient? 䉷 2015 F.A. Davis Company