DORNASE ALFA

DORNASE ALFa
(dor'naze)
Pulmozyme
Classifications: mucolytic;
Therapeutic: mucolytic

Pregnancy Category: B

Availability

1 mg/mL solution for inhalation

Action

Dornase is a solution of recombinant human deoxyribonuclease (DNAse), an enzyme that selectively cleaves DNA. In cystic fibrosis (CF) patients, viscous, purulent secretions in the airway reduce pulmonary function and lead to exacerbations of infection. Purulent pulmonary secretions contain very high concentrations of DNA released by degenerating leukocytes that are present in response to infection.

Therapeutic Effect

Dornase hydrolyzes the DNA in sputum of CF patients and reduces sputum viscosity. Use of dornase significantly reduces number of upper respiratory infections acquired by patients with CF.

Uses

In combination with standard therapies to reduce the frequency of respiratory infections in patients with CF and to improve pulmonary function.

Unlabeled Uses

Chronic bronchitis.

Contraindications

Hypersensitivity to dornase or hamster protein; infants <3 mo.

Cautious Use

Pregnancy (category B), lactation.

Route & Dosage

Cystic Fibrosis
Adult/Child (>3 mo): Inhalation 2.5 mg (1 ampule) inhaled once  daily using a recommended  nebulizer, may increase to twice daily (do not mix with other agents in nebulizer)

Administration

Inhalation
  • Do not dilute or mix with any other drugs or solutions in the nebulizer.
  • Use only with nebulizer systems recommended by the drug manufacturer.
  • Do not shake ampuls; do not use ampuls that have been at room temperature longer than 24 h or have become cloudy or discolored.
  • Store refrigerated at 2°–8° C (36°–46° F) in protective foil pouch.

Adverse Effects (≥1%)

Respiratory: Hoarseness, sore throat, voice alterations, pharyngitis, laryngitis, cough, rhinitis. Other: Conjunctivitis, chest pain, rash.

Pharmacokinetics

Absorption: Minimal systemic absorption. Onset: 3–8 d. Duration: Benefit lasts up to 4 d after discontinuing treatment.

Nursing Implications

Assessment & Drug Effects

  • Monitor for improvement in dyspnea and sputum clearance.
  • Monitor for S&S of hypersensitivity (see Appendix F). Patients with a history of hypersensitivity to bovine pancreatic dornase are at high risk.
  • Monitor for adverse effects; rarely, dosage adjustments may be required.

Patient & Family Education

  • Report rash, hives, itching, or other S&S of hypersensitivity to physician immediately.
  • Know potential adverse effects and report those that are bothersome or do not disappear.
  • Take a missed dose as soon as possible; if it is almost time for the next dose, skip the missed dose.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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© 2006-2017 medpill.info Last Updated On: 07/21/2017 (0.01)
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