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INTRODUCTION

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palivizumab (pal-i-vi-zoo-mab)

Synagis

Classification

Therapeutic: antivirals

Pharmacologic: monoclonal antibodies

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Indications
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Prevention of serious respiratory tract disease due to respiratory syncytial virus (RSV) in children at high risk (infants with bronchopulmonary dysplasia, history of prematurity, or hemodynamically significant congenital heart disease).

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Action
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Neutralizes and inhibits fusion of RSV virus; subsequently inhibits viral replication. Therapeutic Effects: Prevents serious sequelae of RSV disease in susceptible children.

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Adverse Reactions/Side Effects
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GI: diarrhea, vomiting. Local: erythema, induration. Misc: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLACTOID REACTIONS AND ANAPHYLAXIS.

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PHYSICAL THERAPY IMPLICATIONS

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

  • Monitor intramuscular injection site for pain, redness, warmth, and hardening of local tissues. Report prolonged or excessive injection site reactions to the physician.

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Interventions
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  • Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Employ universal precautions as indicated for specific patients.

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Patient/Client-Related Instruction
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  • Instruct family/caregivers to report other troublesome side effects, including severe or prolonged GI problems (vomiting, diarrhea).

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Pharmacokinetics
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Absorption: Well absorbed after IM administration.

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Distribution: Unknown.

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Metabolism and Excretion: Unknown.

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Half-life: 20 days.

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TIME/ACTION PROFILE (antibody levels)

ROUTE ONSET PEAK DURATION
IM rapid unknown 30 days

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity.

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Use Cautiously in: History of thrombocytopenia or bleeding disorders.

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Interactions
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Drug-Drug: None known.

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Route/Dosage
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IM (Children): 15 mg/kg/mo during RSV season (first dose should be administered prior to the RSV season; RSV season is November through April in most Northern Hemisphere countries).

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Availability
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Lyophilized powder for reconstitution and injection: 100 mg/vial. Solution for injection: 50 mg/0.5-mL vial, 100 mg/1-mL vial.

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