HYALURONIDASE, OVINE

Hyaluronidase, Ovine
(hi-a-lu-ron'i-dase)
Amphadase, Vitrase
Classifications: enzyme; absorption and dispersing enhancer;
Therapeutic: absorption and dispersing enhancer

Pregnancy Category: C

Availability

150 units/mL and 200 units/mL for injection; lyophilized powder, 6200 units

Action

Hyaluronidase is a diffusing substance that modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid found in the intercellular substance of connective tissue. It temporarily decreases the viscosity of cellular cement and promotes diffusion of injected fluids or exudates, adding to their absorption.

Therapeutic Effect

It increases the absorption and dispersion of solutions in the intercellular spaces.

Uses

Adjuvant to increase the absorption and dispersion of other injected drugs; hypodermoclysis; adjunct in subcutaneous urography for improving resorption of radiopaque agents.

Unlabeled Uses

Adjunct for ophthalmic anesthesia, treatment of vitreous hemorrhage and diabetic retinopathy.

Contraindications

Hypersensitivity to hyaluronidase or any other ingredient in formulation; concurrent use with dopamine or alpha-agonist drugs; injection into infected or acutely inflamed area, area of swelling due to bites or stings; corneal injection; injection by IV; pregnancy (category C).

Cautious Use

Lactation.

Route & Dosage

Adjuvant to Increase the Absorption and Dispersion of Other Drugs
Adult: 150 units (range: 50–300) added to solution
Child: 150 units (range: 50–300) added to solution

Hypodermoclysis
Adult: 15 units added to each 100 mL of fluid
Child (≥3 y): 15 units added to each 100 mL of fluid

Subcutaneous Urography
Adult: SC 75 units prior to contrast medium
Child: SC 75 units prior to contrast medium

Administration

Subcutaneous or Solution Additive
  • Reconstitute vial with 6.2 mL NS for injection to yield 1000 U/mL. Apply the 5-micron filter needle to the 1 mL syringe in injection kit and further dilute: To produce 50 U/mL, withdraw 0.05 mL reconstituted solution and add 0.95 mL NS. To produce 75 U/mL, withdraw 0.075 mL reconstituted solution and add 0.925 mL NS. To produce 150 U/mL, withdraw 0.15 mL reconstituted solution and add 0.85 mL NS. To produce 300 U/mL, withdraw 0.3 mL reconstituted solution and add 0.7 mL NS. Use immediately after preparation.
  • Give SC prior to contrast media. Do not inject near an infected or acutely inflamed area.
  • Store unopened vial at 2°–8° C (35°–46° F). After reconstitution, store at 20°–25° C (59°–77° F), and use within 6 h. Protect from light.

Adverse Effects (≥1%)

CV: Edema. Other: Injection site reaction (e.g., erythema, irritation); enhanced adverse events associated with coadministered drugs.

Interactions

Drug: salicylates, corticosteroids, estrogens, or h1-blockers may confer partial resistant to the action of hyaluronidase in some tissues.

Nursing Implications

Assessment & Drug Effects

  • Monitor for S&S of hypersensitivity: urticaria, erythema, chills, nausea, vomiting, dizziness, tachycardia, and hypotension. Withhold and notify physician if hypersensitivity occurs.
  • Note: Those receiving large doses of salicylates, cortisone, ACTH, estrogens, or antihistamines may require larger amounts of hyaluronidase for equivalent dispersing effect.

Patient & Family Education

  • Report immediately any of the following: rash, itching, chills, nausea, vomiting, dizziness, or palpitations.

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

(22)
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