Name of the Anti-IgE Antibody
1.Omalizumab
| Omalizumab |
| Availability: Powder for injection: 150 mg/vial |
| Administration and handling: Adults and adolescents ages 12 and older: 150 to 375 mg subcutaneously q 2 to 4 week |
| Mechanism of action: Helps reduce inflammation by binding to circulating IgE and keeping it from binding to mast cells. This action inhibits degranulation and blocks release of histamine and other chemical mediators. In asthma, inflammation results when antigen re-exposure causes mast cells to degranulate and release histamine and chemical mediators. |
| Indications: To treat moderate to severe persistent asthma in patients with positive skin test or in vitro reactivity to a perennial aeroallergen whose symptoms have been inadequately controlled with inhaled corticosteroids |
| Contraindications: Hypersensitivity to drug |
| Precautions: ● elderly patients ● pregnant or breastfeeding patients ● children younger than age 12. |
Patient monitoring
- Monitor patient for severe hypersensitivity reactions, including anaphylaxis.
- Watch for signs and symptoms of cancer (rare).
Patient teaching
- Tell patient to take exactly as prescribed and not to change dosage or stop drug abruptly (unless hypersensitivity reaction occurs).
- Instruct patient to discontinue drug and notify prescriber immediately at first sign of hypersensitivity reaction, such as rash, hives, or itching.
- Inform patient that asthma symptoms may not improve immediately after starting drug.
- Tell patient drug isn’t intended for acute asthma attacks.
- As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.
Nursing Considerations
- Record patient’s weight, and obtain blood IgE levels, as ordered, before starting omalizumab; dosage and dosing frequency are based on these factors.
- To remove reconstituted omalizumab from vial, invert vial for 15 seconds to let solution drain toward stopper. Using a new 3-ml syringe with a 1″ 18G needle, insert needle into inverted vial and position needle tip at the very bottom of solution in the vial stopper. Then pull plunger all the way back to end of syringe barrel to remove all solution from inverted vial. To obtain full 150-mg dose (1 vial containing 1.2 ml of reconstituted omalizumab), you must withdraw all product from vial before expelling any air or excess solution from syringe.
- Don’t give more than 150 mg of omalizumab per injection site.
- Be prepared to inject omalizumab over 5 to 10 seconds because solution is slightly viscous.
REFERENCES
- Robert Kizior, Keith Hodgson, Saunders Nursing Drug handbook,1st edition 2024, Elsevier Publications. ISBN-9780443116070
- McGraw Hill- Drug Handbook, Seventh Edition, 2013, McGraw Hill Education Publications,9780071799430.
- April Hazard, Cynthia Sanoski, Davi’s Drug Guide for Nurses -Sixteenth Edition 2019, FA Davis Company Publications,9780803669451.
- Jones and Bartlet, Pharmacology for Nurses, Second Edition, 2020, Jones and Bartlet Learning Publications, ISBN 9781284141986.
- Nursebro.com, Search – Nursebro
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