Interferon Gamma-1B

INTRODUCTION

Indications

Diminished severity and frequency of infectious complications of chronic granulomatous disease. Slow disease progression in severe, malignant osteopetrosis.

Action

A protein produced by recombinant DNA technology that is capable of activating phagocytes, enhancing their ability to kill pathogens, including Staphylococcus aureus, Toxoplasma gondii, Leishmania donovani, Listeria monocytogenes, Mycobacterium avium intracellulare. Interferon gamma has antiproliferative effects superior to interferons alpha and beta. Therapeutic Effects: Decreased incidence and severity of infection in patients with chronic granulomatous disease. Slowed disease progression of severe, malignant osteopetrosis.

Adverse Reactions/Side Effects

CNS: headache, decreased mental status, dizziness. GI: nausea, vomiting, abdominal pain. Derm: rash. Hemat: neutropenia, thrombocytopenia. Local: edema or tenderness at injection site. MS: arthralgia, myalgia, back pain. Neuro: gait disturbances. Misc: chills, fever.

PHYSICAL THERAPY IMPLICATIONS

• Monitor signs of neutropenia (fever, sore throat, signs of infection) or thrombocytopenia (bruising, nose bleeds, bleeding gums). Report these signs to the physician immediately.

• Assess any gait abnormalities that might be drug induced. Attempt to rule out neuromuscular causes of gait problems, and report any unexplained gait disturbances to the physician.

• Monitor personality changes or decreased mental status. Notify physician if these changes become problematic.

• Assess any joint, muscle, or back pain to rule out musculoskeletal pathology; that is, try to determine if pain is drug-induced rather than caused by anatomic problems or problems related directly to the underlying condition (osteopetrosis or joint infections).

• 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.

Interventions

• Use caution during therapeutic exercises to avoid fracture in patients with osteopetrosis. Implement appropriate resistive exercises as tolerated to maintain muscle strength and promote normal bone mineralization.

Patient/Client-Related Instruction

• Instruct patient to report other troublesome side effects such as prolonged or severe headache, chills, fever, skin rash, or GI problems (nausea, vomiting, abdominal pain).

Pharmacokinetics

Absorption: Well absorbed after SC administration.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: 5.9 hr.

Contraindications/Precautions

Contraindicated in: Hypersensitivity to interferon gamma, Escherichia coli–derived products, mannitol, or ...