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INTRODUCTION

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interferon alfacon-1 (in-ter-feer-on al-fa-kon-won)

Infergen

Classification

Therapeutic: immune modifiers

Pharmacologic: interferons

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Indications
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Treatment of chronic hepatitis C infection (HCV).

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Action
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Antiproliferative, antiviral, and immunomodulatory effects. Therapeutic Effects: Improvement in liver function studies, liver histology, and decreased hepatitis C viral RNA concentration.

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Adverse Reactions/Side Effects
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CNS: anxiety, depression, dizziness, insomnia, nervousness, malaise, suicidal ideation. EENT: loss of visual acuity or visual field, tinnitus. GI: abdominal pain, anorexia, diarrhea, dyspepsia, vomiting, constipation, dry mouth, flatulence. Derm: alopecia, pruritus, rash. Endo: hypothyroidism. Hemat: ANEMIA, LEUKOPENIA, THROMBOCYTOPENIA. Local: injection site reactions. MS: body pain. Neuro: paresthesia. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS, flu-like symptoms (headache, fatigue, fever).

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor signs of leukopenia (fever, sore throat, signs of infection), thrombocytopenia (bruising, nose bleeds, bleeding gums), or unusual weakness and fatigue that might be due to anemias or other blood dyscrasias. Report these signs to the physician immediately.

  • Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea), or skin reactions (rash, pruritus, urticaria, dermatitis). Notify physician or nursing staff immediately if these reactions occur.

  • Monitor personality changes, including anxiety, nervousness, depression, and increased thoughts of suicide. Notify physician if these changes become problematic.

  • Assess any joint pain or muscle pain to rule out musculoskeletal pathology; that is, try to determine if pain is drug induced rather than caused by anatomic or biomechanical problems.

  • Monitor signs of paresthesia (numbness, tingling). Perform objective tests (nerve conduction, monofilaments) to document any neuropathic changes.

  • Monitor and report any signs of hypothyroidism, including bradycardia, lethargy, cold intolerance, weight gain, and muscle weakness.

  • Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and trauma.

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

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Interventions
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  • Implement resistive exercises and other therapeutic exercises as tolerated to maintain muscle strength and function in patients with chronic hepatitis.

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Patient/Client-Related Instruction
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  • Advise patient about the likelihood of GI reactions, including nausea, vomiting, diarrhea, constipation, flatulence, dry mouth, and loss of appetite. Instruct patient to report severe or prolonged GI problems.

  • Instruct patient to report other troublesome side effects such as prolonged or severe vision disturbances, ringing/buzzing in the ears (tinnitus), flulike symptoms, or skin problems (rash, itching, hair loss)

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Pharmacokinetics
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Absorption: Well absorbed following SC administration.

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Distribution: Unknown.

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Metabolism and Excretion: Unknown.

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