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INTRODUCTION

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pegaptanib (peg-ap-ta-nib)

Macugen

Classification

Therapeutic: ocular agents

Pharmacologic: vascular endothelial growth-factor antagonists

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Indications
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Neovascular (wet) age-related macular degeneration.

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Action
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Acts as an antagonist of vascular endothelial growth factor (VEGF). VEGF may be responsible for the formation of incompetent, leaky blood vessels associated with macular degeneration. Therapeutic Effects: Decreased rate of loss of visual acuity.

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Adverse Reactions/Side Effects
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EENT: cataract, blurred vision, conjunctival bleeding, irritation/pain, ↑ intraocular pressure, ocular inflammation, infection (rare), retinal detachment (rare), traumatic cataract formation (rare). Misc: Anaphylaxis, angioedema.

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PHYSICAL THERAPY IMPLICATIONS

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

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Patient/Client-Related Instruction
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  • Advise patient about the likelihood of vision disturbances, including blurred vision, cloudy vision, and eye inflammation. Instruct patient to report severe or unexpected vision problems.

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Pharmacokinetics
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Absorption: Slowly absorbed into systemic circulation after intravitreous administration.

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Distribution: Unknown.

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Metabolism and Excretion: Metabolized by exonucleases and endonucleases.

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Half-life: 10 days (plasma).

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TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION
intravitreal unknown unknown 6 wk

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Contraindications/Precautions
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Contraindicated in: Ocular/periocular infections.

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Use Cautiously in: OB: Use only if maternal benefit outweighs fetal risk; Lactation/Pedi: Safety not established.

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Interactions
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Drug-Drug: None known.

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Route/Dosage
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Intravitreal (Adults): 0.3 mg q 6 wk.

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Availability
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Solution for intravitreous injection: 0.3 mg/mL in 1-mL single use glass syringes.

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