Home Drug Guide Asparaginase Erwinia Chrysanthemi (recombinant)-rywn

Drug Guide

Generic Name

Asparaginase Erwinia Chrysanthemi (recombinant)-rywn

Brand Names Rylaze

Classification

Therapeutic: Antineoplastic agent (asparagine-specific enzyme)

Pharmacological: Enzyme, asparaginase

FDA Approved Indications

  • Acute lymphoblastic leukemia (ALL) in patients who have hypersensitivity to E. coli-derived asparaginase

Mechanism of Action

Depletes circulating asparagine by catalyzing the hydrolysis of asparagine to aspartic acid and ammonia, depriving leukemia cells of an amino acid essential for their survival.

Dosage and Administration

Adult: Dose varies based on protocol; typically administered intravenously or intramuscularly under supervision.

Pediatric: Dose individualized based on body surface area or weight; administration route similar to adults.

Geriatric: No specific dosage adjustments, but monitor closely due to potential comorbidities.

Renal Impairment: Adjust as clinically indicated; no specific guidelines.

Hepatic Impairment: Use with caution; monitor liver function closely.

Pharmacokinetics

Absorption: Rapidly absorbed when given intramuscularly or intravenously.

Distribution: Widely distributed in tissues and blood.

Metabolism: Metabolized by proteolytic pathways; specific pathways not fully characterized.

Excretion: Eliminated primarily via the reticuloendothelial system; minimal renal excretion.

Half Life: Approximately 1.15 days (varies with route and individual patient factors).

Contraindications

  • Hypersensitivity to E. coli-derived asparaginase or any component of the formulation.

Precautions

  • Risk of allergic reactions, including anaphylaxis; monitor closely.
  • Pancreatitis, coagulopathy, hepatotoxicity; monitor labs regularly.
  • Use with caution in patients with bleeding disorders or hepatic impairment.

Adverse Reactions - Common

  • Allergic reactions including anaphylaxis (Varies; up to 10% in some studies)
  • Liver enzyme elevations (Common)
  • Pancreatitis (Less common)

Adverse Reactions - Serious

  • Anaphylaxis (Rare)
  • Pancreatitis leading to necrosis (Rare)
  • Severe hypersensitivity reactions (Rare)
  • Coagulopathy or bleeding complications (Less common)

Drug-Drug Interactions

  • Corticosteroids may exacerbate immunosuppression.
  • Chemotherapy agents may have additive effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for allergic reactions, signs of pancreatitis, liver function tests, and coagulation profiles.

Diagnoses:

  • Risk for allergic reaction
  • Risk for bleeding or hemorrhage
  • Potential for hepatic toxicity

Implementation: Administer as prescribed, monitor vital signs, and observe for adverse reactions.

Evaluation: Assess effectiveness by reduction in leukemia cell count and monitor for adverse events.

Patient/Family Teaching

  • Report any signs of allergic reactions immediately.
  • Inform about possible side effects such as nausea, headache, or changes in bleeding.
  • Follow storage instructions for medication.

Special Considerations

Black Box Warnings:

  • Severe hypersensitivity reactions, including anaphylaxis, can occur.
  • Risk of serious blood clotting and hemorrhaging.

Genetic Factors: No specific genetic markers impacting use established.

Lab Test Interference: Can cause elevations in liver function tests, coagulation parameters, and serum amylase/lipase, which should be interpreted with caution.

Overdose Management

Signs/Symptoms: Allergic reactions, hypersensitivity presenting as anaphylaxis, coagulopathy, or pancreatitis.

Treatment: Discontinue drug, provide supportive care, and manage symptoms; consider antihistamines, corticosteroids, or epinephrine for allergic reactions.

Storage and Handling

Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F).

Stability: Stable under recommended storage conditions; do not freeze.

🛡️ 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.