++
palifermin (pa-lif-er-min)
Kepivance
Classification
Therapeutic: cytoprotective agents
Pharmacologic: keratinocyte growth factors (rDNA)
++
To decrease incidence/duration of severe oral mucositis associated with myelotoxic therapy requiring stem cell support for hematologic malignancies.
++
Enhances proliferation of epithelial cells. Therapeutic Effects: Decreased incidence/duration of mucositis.
+++
Adverse Reactions/Side Effects
++
Derm: skin toxicity. GI: oral toxicity. Metab: ↑ amylase, ↑ lipase. MS: arthralgia. Neuro: dysesthesia.
+++
PHYSICAL THERAPY IMPLICATIONS
+++
Examination and Evaluation
++
Monitor any skin reactions, including rash, itching, irritation, and exfoliation. Report any suspicious or toxic skin reactions to the physician or nursing staff.
Assess any joint 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 and report any changes in taste or other unusual sensations such as burning, tingling, or painful responses to touch (dysesthesia).
+++
Patient/Client-Related Instruction
++
++
Absorption: IV administration results in complete bioavailability.
++
Distribution: Distributes into extravascular space.
++
Metabolism and Excretion: Unknown.
++
++
+++
Contraindications/Precautions
++
Contraindicated in: Hypersensitivity to palifermin or other Escherichia coli–derived proteins.
++
Use Cautiously in: OB: Pregnancy (use only if maternal benefit outweighs fetal risk); Pedi: Children, lactation (safety not established).
++
Drug-Drug: Binds to and inactivates heparin (flush tubing between use). Administration within 24 hr after myelotoxic therapy (chemotherapy/radiation) ↑ severity and duration of mucositis.
++
IV (Adults): 60 mcg/kg/day for 3 days before and 3 days after myelotoxic therapy.
++
Powder for injection: 6.25 mg/vial.