Names and pronunciation
(pa-lone-o′se-tron) Aloxi
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Individual generic drug information
Extracted information for palonosetron only.
(pa-lone-o′se-tron) Aloxi
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Func. class.: Antiemetic
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Chem. class.: 5-HT3 receptor antagonist
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ACTION: Prevents nausea, vomiting by blocking serotonin peripherally, centrally, and in the small intestine at the 5-HT3 receptor
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USES: Prevention of nausea, vomiting associated with cancer chemotherapy, postoperative nausea/vomiting
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Extracted information for palonosetron only.
CONTRAINDICATIONS: Hyper sensitivity Precautions: Pregnancy, breastfeeding, children, geriatric patients, hypokalemia, hypomagnesemia, patients taking diuretics
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SIDE EFFECTS CNS: Headache, dizziness, drowsiness, fatigue, insomnia, fever, anxiety GI: Diarrhea, constipation MISC: Serotonin syndrome INTEG: Rash RESP: Bronchospasm CV: Hyperkalemia GU: Urinary retention
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INTERACTIONS • Increase: QT prolongation: class IA antidysrhythmics (disopyramide, procain- amide, quiNIDine), class III antidysrhyth- mics (amiodarone, dofetilide, ibutilide, sotalol), chloroquine, clarithromycin, dro- peridol, erythromycin, haloperidol, metha- done, pentamidine, some phenothiazines, diuretics (except potassium sparing) Increase: hypotension, severe— apomorphine Increase: serotonin syndrome: buspi- rone, fentanyl, lithium, methylene blue, Tramadol, SSRIs, SNRIs, MAOIs, tricyclics, triptans Drug/Lab Increase: potassium
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Extracted information for palonosetron only.
DOSAGE AND ROUTES Prevention of chemotherapy- induced nausea/vomiting • Adult: IV 0.25 mg as single dose over 30 sec ½ hr before chemotherapy Child 1 mo to <17 yr: IV 20 mcg/kg, max 1.5 mg given 30 min before chemo- therapy Postoperative nausea/vomiting prophylaxis for ≤24 hr after surgery • Adult: IV 0.075 mg given over 10 sec immediately before induction
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Available forms: Inj 0.075 mg/1.5 mL, 0.25 mg/5 mL single use
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Administer: Direct IV route • Inspect for particulate, discoloration • Give 30 min before chemotherapy or immediately before anesthesia • Do not admix with other products, flush IV line with 0.9% NaCL before and after use • No dilution needed • Chemotherapy nausea/vomiting: give as single dose over 30 sec • Postoperative nausea/vomiting: give over 10 sec immediately before anesthe- sia induction
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Extracted information for palonosetron only.
Assess: • For agents that cause QT prolongation, even if manufacturer has removed QT prolongation from warnings • Absence of nausea, vomiting during chemotherapy • Hypersensitivity reaction: rash, bron- chospasm (rare) • CV disease: ECG prior to use • Hyperkalemia: potassium baseline and periodically • Pregnancy/breastfeeding: use only if clearly needed; do not breastfeed
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Evaluate: • Therapeutic response: absence of nau- sea, vomiting during cancer chemother- apy, postoperatively
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To report diarrhea, constipation, rash, changes in respirations, or discomfort at insertion site • To avoid alcohol, barbiturates • Use other antiemetics if nausea occurs • Reason for product, expected results
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Extracted information for palonosetron only.
PHARMACOKINETICS 62% protein bound; metabolized by liver; unchanged product and metabolites excreted by kidney; terminal elimination half-life 40 hr
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Filter the extracted dose blocks for this individual drug.
Prevention of chemotherapy- induced nausea/vomiting
• Adult: IV 0.25 mg as single dose over 30 sec ½ hr before chemotherapy Child 1 mo to <17 yr: IV 20 mcg/kg, max 1.5 mg given 30 min before chemo- therapy Postoperative nausea/vomiting prophylaxis for ≤24 hr after surgery
Candidate age grouping · source page 1012
Prevention of chemotherapy- induced nausea/vomiting
• Adult: IV 0.075 mg given over 10 sec immediately before induction
Candidate age grouping · source page 1012