Home Drug Guide Palivizumab

Drug Guide

Generic Name

Palivizumab

Brand Names Synagis

Classification

Therapeutic: Immunization/Passive Immunity

Pharmacological: Monoclonal Antibody

FDA Approved Indications

  • Prevention of serious lower respiratory tract disease caused by Respiratory Syncytial Virus (RSV) in pediatric patients at high risk

Mechanism of Action

Palivizumab is a humanized monoclonal antibody that binds to the F protein of RSV, inhibiting viral fusion and entry into host cells, thereby preventing infection and disease progression.

Dosage and Administration

Adult: N/A – Used in pediatric populations only

Pediatric: 15 mg/kg IM once monthly during RSV season, typically for up to 5 doses depending on risk

Geriatric: N/A – Primarily used in children at high risk

Renal Impairment: No dose adjustment needed for mild to moderate impairment

Hepatic Impairment: No specific recommendations available

Pharmacokinetics

Absorption: IM administration with peak serum concentrations in about 2-4 days

Distribution: Primarily in vascular and extravascular compartments

Metabolism: Catabolized into small peptides and amino acids

Excretion: Eliminated via normal protein catabolic pathways

Half Life: Approximately 20 days

Contraindications

  • Hypersensitivity to Palivizumab or any component of the formulation

Precautions

  • Use with caution in patients with a history of hypersensitivity reactions, including serious allergic reactions. Not a substitute for active immunization.

Adverse Reactions - Common

  • Injection site reactions (redness, swelling, pain) (Common)
  • Fever (Less common)

Adverse Reactions - Serious

  • Anaphylaxis (Rare)
  • Neurotoxicity or hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • No significant interactions identified

Drug-Food Interactions

  • None

Drug-Herb Interactions

  • None

Nursing Implications

Assessment: Monitor for adverse reactions following administration, especially allergic responses.

Diagnoses:

  • Risk for allergic reaction
  • Impaired tissue integrity related to injection site reactions

Implementation: Administer via IM injection in the anterolateral thigh muscle. Ensure proper refrigeration of the medication.

Evaluation: Assess for adverse reactions or allergic responses post-injection, and document compliance with dosing schedule.

Patient/Family Teaching

  • Explain the purpose of the injections and the importance of completing the full course during RSV season.
  • Report any allergic reactions, rash, difficulty breathing, or swelling to healthcare provider immediately.
  • Notify healthcare provider if symptoms of RSV develop.

Special Considerations

Black Box Warnings:

  • Potential for hypersensitivity reactions, including anaphylaxis.

Genetic Factors: No known genetic factors affecting response.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Allergic reactions, including rash, swelling, difficulty breathing

Treatment: Immediate initiation of emergency measures, including administration of epinephrine, antihistamines, corticosteroids, and supportive care as needed.

Storage and Handling

Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable in unopened vials until expiration date; once reconstituted, use immediately or store as per manufacturer guidelines.

🛡️ 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.