Home Drug Guide Panitumumab

Drug Guide

Generic Name

Panitumumab

Brand Names Vectibix

Classification

Therapeutic: Antineoplastic Agent

Pharmacological: Monoclonal Antibody (EGFR inhibitor)

FDA Approved Indications

  • Metastatic colorectal cancer (KRAS wild-type)

Mechanism of Action

Panitumumab binds to the epidermal growth factor receptor (EGFR), preventing the activation of the receptor and subsequent downstream signaling that promotes tumor cell proliferation.

Dosage and Administration

Adult: Initial dose of 6 mg/kg given intravenously every 2 weeks.

Pediatric: Not approved or recommended for pediatric use.

Geriatric: Adjust based on tolerability; no specific dose adjustment required solely based on age.

Renal Impairment: No specific adjustment; caution in severe impairment.

Hepatic Impairment: No specific adjustment; caution advised.

Pharmacokinetics

Absorption: Not applicable (intravenous infusion).

Distribution: Widely distributed; volume of distribution approximately 5-8 liters.

Metabolism: Metabolized through catabolism, not via liver enzymes.

Excretion: Excreted via protein catabolism, not renal or hepatic pathways.

Half Life: Approximately 4.5 days.

Contraindications

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

Precautions

  • Risk of dermatologic toxicity, infusion reactions, electrolyte abnormalities, interstitial lung disease.
  • Use caution in patients with pre-existing pulmonary fibrosis or interstitial lung disease.

Adverse Reactions - Common

  • Skin rash (Common)
  • Fatigue (Common)
  • Pruritus (Common)
  • Diarrhea (Common)

Adverse Reactions - Serious

  • Infusion reactions (Less common)
  • Interstitial lung disease (Rare)
  • Electrolyte imbalances (hypomagnesemia, hypocalcemia) (Less common)
  • Dermatologic toxicity leading to severe skin reactions (Less common)

Drug-Drug Interactions

  • Concomitantuse with other EGFR inhibitors or chemotherapeutics

Drug-Food Interactions

  • No significant food interactions reported.

Drug-Herb Interactions

  • Limited data; caution with herbal supplements with potential for skin toxicity or bleeding.

Nursing Implications

Assessment: Monitor for skin reactions, infusion reactions, electrolyte disturbances, pulmonary status.

Diagnoses:

  • Risk for skin impairment
  • Risk for infusion reactions
  • Electrolyte imbalance

Implementation: Administer as per schedule, monitor infusion closely, assess for adverse effects, correct electrolyte imbalances before therapy.

Evaluation: Assess for reduction in tumor size, monitor blood work, watch for adverse reactions.

Patient/Family Teaching

  • Report any signs of allergic reactions, skin rash, or difficulty breathing immediately.
  • Maintain hydration and electrolyte balance.
  • Protect skin from sun exposure and report severe skin changes.

Special Considerations

Black Box Warnings:

  • Serious infusion reactions, dermatologic toxicity, pulmonary events such as interstitial lung disease.
  • Potential for promotes tumor escape via mutation in downstream signaling pathways.

Genetic Factors: KRAS mutation status should be determined; only KRAS wild-type tumors respond.

Lab Test Interference: May cause hypomagnesemia, hypocalcemia — monitor electrolytes.

Overdose Management

Signs/Symptoms: Signs of overdose may include severe rash, electrolyte disturbances, or infusion reactions.

Treatment: Supportive care, stop infusion, treat symptoms according to severity; no known specific antidote.

Storage and Handling

Storage: Store refrigerated at 2-8°C, do not freeze.

Stability: Stable for up to 24 hours at room temperature after preparation; use promptly.

🛡️ 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.