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INTRODUCTION

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ranibizumab (ran-i-bi-zoo-mab)

Lucentis

Classification

Therapeutic: ocular agents

Pharmacologic: monoclonal antibodies

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Indications
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Treatment of neovascular (wet) macular degeneration.

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Action
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Binds to vascular endothelial growth factor A (VEGF-A) receptor sites, preventing the binding of endogenous VEGF-A, resulting in ↓ endothelial proliferation, vascular leakage, and new vessel formation. Therapeutic Effects: ↓ progression of visual loss.

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Adverse Reactions/Side Effects
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EENT: conjunctival hemorrhage, eye pain, ↑ intraocular pressure, intraocular inflammation, vitreal floaters, endophthalmitis, retinal detachment. CV: arterial thromboembolic events.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor any eye pain, conjunctival hemorrhage, or other eye problems. Be alert for balance or mobility deficits that may indicate worsening vision. Report these findings to the physician.

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Interventions
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  • Guard against falls and trauma. Implement fall-prevention strategies, especially if patient exhibits blurred vision or other visual impairments (See Appendix E).

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Patient/Client-Related Instruction
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  • Instruct patient to report any loss of vision that might indicate increased intraocular pressure or other vision problems.

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Pharmacokinetics
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Absorption: Intravitreal injection results in complete local bioavailability. Very low serum levels are achieved.

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Distribution: Unknown.

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Metabolism and Excretion: Unknown.

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Half-life: 9 days (intravitreal).

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TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION
intravitreal unknown after injection 1 mo

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity; Ocular/periocular infections.

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Use Cautiously in: OB: Use only in pregnancy if clearly needed, use cautiously during lactation; Pedi: Safe use in children not established.

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Interactions
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Drug-Drug: ↑ risk of serious intraocular inflammation with verteporfin.

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Route/Dosage
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Intravitreal (Adults): 0.5 mg (0.05 mL) once monthly; after 4 mo, injections may be given q 1–3 mo.

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Availability
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Solution for intravitreal injection: each vial delivers 0.5 mg (0.05 mL).

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