Home Drug Guide Rasburicase

Drug Guide

Generic Name

Rasburicase

Brand Names Elitek

Classification

Therapeutic: Antineoplastic, Urate-Lowering Agent

Pharmacological: Recombinant Uricase Enzyme

FDA Approved Indications

  • Prevention and treatment of hyperuricemia related to tumor lysis syndrome in pediatric and adult patients with hematologic cancers

Mechanism of Action

Rasburicase catalyzes the conversion of uric acid into allantoin, which is more soluble and easily excreted by the kidneys, thereby reducing serum uric acid levels.

Dosage and Administration

Adult: Calculate dose based on body weight; administer intravenously over 30 minutes. Dose typically 0.2 mg/kg daily for up to 5 days.

Pediatric: Dosing based on body surface area or weight; administer intravenously over 30 minutes. Dosing varies; consult specific guidelines.

Geriatric: Use with caution; adjust dose if renal impairment present.

Renal Impairment: Adjust dosage based on renal function; monitor closely.

Hepatic Impairment: No specific adjustments indicated.

Pharmacokinetics

Absorption: Not applicable (administered IV).

Distribution: Distributed in extracellular fluid; high-volume distribution.

Metabolism: Metabolized by proteolytic enzymes; not renal or hepatic.

Excretion: Excreted as allantoin via urine.

Half Life: Approximately 19 hours.

Contraindications

  • History of hypersensitivity to rasburicase or any component.
  • G6PD deficiency.

Precautions

  • Risk of hemolysis in G6PD deficiency; screen prior to administration.
  • Use with caution in patients with glucose-6-phosphate dehydrogenase deficiency; may cause hemolytic anemia.
  • Monitor for allergic reactions, including anaphylaxis.

Adverse Reactions - Common

  • Pyrexia (Common)
  • Nausea (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Anaphylaxis (Rare)
  • Hemolytic anemia, especially in G6PD deficiency (Rare)
  • Methemoglobinemia (Rare)

Drug-Drug Interactions

  • None specifically noted, but caution with other drugs affecting G6PD status.

Drug-Food Interactions

  • No significant interactions noted.

Drug-Herb Interactions

  • Limited data; avoid unless known safe.

Nursing Implications

Assessment: Screen for G6PD deficiency before administration. Monitor serum uric acid levels, renal function, and for allergic reactions.

Diagnoses:

  • Risk for Hemolytic Anemia
  • Impaired renal function due to uric acid nephropathy

Implementation: Administer IV as per dosing schedule. Ensure patient is monitored during and after infusion.

Evaluation: Assess reduction in uric acid levels, renal function, and any allergic reactions.

Patient/Family Teaching

  • Inform about the purpose of medication and possible side effects.
  • Report signs of allergic reactions or unusual bleeding.
  • Explain the importance of G6PD screening prior to administration.

Special Considerations

Black Box Warnings:

  • Hemolysis risk in G6PD deficiency.

Genetic Factors: G6PD deficiency testing required before use.

Lab Test Interference: May artificially lower serum uric acid levels; interpret results with caution.

Overdose Management

Signs/Symptoms: Allergic reactions, hemolytic anemia, methemoglobinemia.

Treatment: Supportive care; discontinue drug, provide oxygen or transfusions as needed, emergency management for anaphylaxis.

Storage and Handling

Storage: Store in a refrigerator at 2°C to 8°C (36°F to 46°F).

Stability: Stable until the expiration date when stored properly.

🛡️ 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.