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INTRODUCTION

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ecallantide (ee-kal-lan-tide)

Kalbitor

Classification

Therapeutic: antiangioedema agents

Pharmacologic: kallikrein inhibitors

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Indications
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Treatment of acute attacks of hereditary angioedema (HAE) in patients ≥16 yr.

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Action
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Acts as a selective, reversible inhibitor of kallikrein, thereby inhibiting its action in initiating bradykinin production, part of the cascade of events in HAE. Therapeutic Effects: Decreased severity of attack of HAE.

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Adverse Reactions/Side Effects
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CNS: headache, fatigue. EENT: nasopharyngitis. GI: nausea, abdominal pain, diarrhea. Derm: pruritus, rash, urticaria. Local: injection-site reactions. Misc: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS, fever.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Watch for signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria, dermatitis, welts, burning/itching skin, swelling in the face). Notify physician or nursing staff immediately if these reactions occur.

  • Monitor subcutaneous injection site for pain, swelling, and irritation. Report prolonged or excessive injection site reactions to the physician.

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Patient/Client-Related Instruction
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  • Instruct patient to report other troublesome side effects such as prolonged or severe headache, fatigue, fever, upper respiratory tract irritation, skin reactions (rash, itching, hives), or GI problems (nausea, diarrhea, abdominal pain).

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Pharmacokinetics
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Absorption: Well absorbed following subcutaneous administration.

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Distribution: Unknown.

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Metabolism and Excretion: Renally eliminated.

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Half-life: 2 hr.

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TIME/ACTION PROFILE (symptom improvement)

ROUTE ONSET PEAK DURATION
SC unknown 2–4 hr up to 24 hr

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity.

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Use Cautiously in: Geri: Consider age-related ↓ in hepatic, renal, or cardiac function, concomitant diseases or other drug therapy; lower initial dose may be considered; Lactation: Use cautiously; OB: Use only if clearly needed.

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Interactions
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Drug-Drug: None noted.

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Route/Dosage
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Subcut (Adults ≥ 16 yr): 30 mg given as 3 10-mg injections; an additional dose of 30 mg may be given within 24 hr.

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Availability
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Injection for subcutaneous use: 10 mg/mL.

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