Nurses Compass
Drug Guide
Reslizumab
Classification
Therapeutic: Antiasthmatic, Anti-inflammatory
Pharmacological: Interleukin-5 (IL-5) inhibitor
FDA Approved Indications
- Add-on maintenance treatment of severe eosinophilic asthma in patients aged 18 years and older
Mechanism of Action
Reslizumab is a monoclonal antibody that selectively binds to IL-5, reducing its activity. This decreases eosinophil levels, which are involved in the inflammatory process of eosinophilic asthma.
Dosage and Administration
Adult: 3 mg IV infusion every 4 weeks; administer over 20-50 minutes.
Pediatric: Not approved for pediatric use.
Geriatric: No specific dosage adjustments, but use with caution in elderly due to potential comorbidities.
Renal Impairment: No specific dose adjustment required.
Hepatic Impairment: No specific dose adjustment required.
Pharmacokinetics
Absorption: Administered intravenously; absorption phase not applicable.
Distribution: Widely distributed in tissues; large volume of distribution.
Metabolism: Catabolized into small peptides and amino acids via proteolytic enzymes.
Excretion: Primarily via proteolytic pathways; not eliminated unchanged in urine.
Half Life: Approximately 24 days.
Contraindications
- Hypersensitivity to reslizumab or any component of the formulation.
Precautions
- Potential for hypersensitivity reactions, including anaphylaxis; monitor during and after infusion.
- Use with caution in patients with eosinophilic conditions other than asthma.
Adverse Reactions - Common
- Oropharyngeal pain (Common)
- Wheezing (Common)
- Anaphylaxis, angioedema (Rare but serious)
Adverse Reactions - Serious
- Anaphylaxis (Rare)
- Herpes zoster infections (Uncommon)
Drug-Drug Interactions
- None specifically; however, concomitant use of other biologics or immunosuppressants may increase risk of infections.
Drug-Food Interactions
- No known significant interactions.
Drug-Herb Interactions
- Limited data; caution with herbal supplements that affect immune response.
Nursing Implications
Assessment: Evaluate eosinophil counts and asthma control prior to administration.
Diagnoses:
- Ineffective airway clearance related to airway inflammation.
- Risk for allergic reaction. assets: monitor for hypersensitivity during and after infusion.
Implementation: Administer IV infusion as prescribed; monitor for infusion reactions.
Evaluation: Assess for improvement in asthma symptoms and monitor for adverse effects.
Patient/Family Teaching
- Inform about possible side effects including allergic reactions.
- Advise on the importance of regular follow-up and blood tests.
- Instruct to report any signs of allergic reactions immediately.
Special Considerations
Black Box Warnings:
- Anaphylaxis has been reported; patients should be observed during and after infusion.
Genetic Factors: None specifically noted for reslizumab.
Lab Test Interference: May affect eosinophil counts; interpret laboratory results accordingly.
Overdose Management
Signs/Symptoms: Potential allergic reactions or infusion site reactions.
Treatment: Discontinue infusion immediately; provide supportive care including antihistamines, corticosteroids, epinephrine if necessary.
Storage and Handling
Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F).
Stability: Stable under recommended storage conditions until the expiration date on the label.