Home Drug Guide Bevacizumab

Drug Guide

Generic Name

Bevacizumab

Brand Names Avastin

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Vascular endothelial growth factor (VEGF) inhibitor

FDA Approved Indications

  • Metastatic colorectal cancer
  • Non-squamous non-small cell lung cancer
  • Glioblastoma multiforme
  • Persistent/recurrent glioma in adults
  • Metastatic cervical cancer
  • Ovarian, fallopian tube, or primary peritoneal carcinoma

Mechanism of Action

Bevacizumab is a monoclonal antibody that binds to VEGF, preventing it from activating its receptors on endothelial cells, thereby inhibiting angiogenesis that tumors need for growth and metastasis.

Dosage and Administration

Adult: Typically administered intravenously at 5-15 mg/kg every 2-3 weeks, depending on the indication.

Pediatric: Not generally used in pediatric populations; data limited.

Geriatric: No specific dose adjustment, but elderly patients should be monitored closely for hypertension and bleeding.

Renal Impairment: Use with caution; no specific dose adjustment recommended.

Hepatic Impairment: No specific data, use caution.

Pharmacokinetics

Absorption: Administered intravenously, bypassing absorption barriers.

Distribution: Widely distributed in body tissues; volume of distribution approximately 5-7 liters.

Metabolism: Broken down by proteolytic enzymes into small peptides and amino acids.

Excretion: Metabolized; not eliminated renally or hepatically in intact form.

Half Life: Approximately 20 days.

Contraindications

  • Known hypersensitivity to Bevacizumab or any component of the formulation.

Precautions

  • Risk of bleeding, gastrointestinal perforation, wound healing complications, hypertension, proteinuria, thromboembolic events. Use with caution in patients with wound healing issues or recent surgery.

Adverse Reactions - Common

  • Hypertension (Common)
  • Proteinuria (Common)
  • Fatigue (Common)
  • Anemia (Common)

Adverse Reactions - Serious

  • Gastrointestinal perforation (Rare)
  • Severe bleeding (Rare)
  • Hemorrhage (Rare)
  • Impaired wound healing (Rare)
  • Hypertensive crisis (Rare)

Drug-Drug Interactions

  • Increased risk of bleeding with anticoagulants or antiplatelet agents.
  • Limited data on interactions; monitor closely.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure regularly, watch for signs of bleeding, wound healing status, proteinuria, and signs of thrombosis.

Diagnoses:

  • Risk for bleeding,
  • Risk for impaired skin integrity

Implementation: Administer IV infusion as prescribed. Monitor for adverse effects. Educate patient on signs of complications.

Evaluation: Assess treatment response and adverse reactions periodically; adjust therapy accordingly.

Patient/Family Teaching

  • Report any bleeding, unusual symptoms, wound healing issues, or new hypertension.
  • Avoid invasive procedures without consulting healthcare provider.
  • Maintain regular blood pressure monitoring and follow-up appointments.

Special Considerations

Black Box Warnings:

  • Gastrointestinal perforation, wound healing complications, hemorrhage, severe bleeding, surgery or trauma risk

Genetic Factors: Limited data; no specific genetic testing recommended.

Lab Test Interference: May cause proteinuria and hypertension, monitored via urine protein and blood pressure tests.

Overdose Management

Signs/Symptoms: Potential for increased risk of bleeding, hypertension, or other adverse effects.

Treatment: Supportive care; management of symptoms; no specific antidote. Discontinue infusion and provide symptomatic treatment as needed.

Storage and Handling

Storage: Store vials at 2-8°C, protect from light. Use immediately after reconstitution.

Stability: Stable for 24 hours at room temperature after reconstitution; follow package insert for specific stability data.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.