Nurses Compass
Drug Guide
Palivizumab
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.