palonosetron hydrochloride

palonosetron hydrochloride

Aloxi

Pharmacologic class: Selective serotonin subtype 3 (5-HT₃) receptor antagonist

Therapeutic class: Antiemetic

Pregnancy risk category B

Action

Selectively binds to and antagonizes 5-HT₃ receptors on vagal nerve terminals and in chemoreceptor trigger zone. This action blocks serotonin release, reducing the vomiting reflex.

Availability

Solution: 0.25 mg (free base) in 5-ml vial

⊘Indications and dosages

➣ To prevent nausea and vomiting caused by cancer chemotherapy

Adults: 0.25 mg I.V. as a single dose 30 minutes before chemotherapy. Repeated doses within 7 days aren't recommended.

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hypersensitivity to other 5-HT₃ receptor antagonists
• diabetes mellitus, hepatic dysfunction
• pregnant or breastfeeding patients
• children.

Administration

• Flush I.V. line with normal saline solution before and after giving.
• Deliver into I.V. line over 30 seconds. Don't mix with other drugs.

Route	Onset	Peak	Duration
I.V.	Unknown	Unknown	Unknown

Adverse reactions

CNS: headache, fatigue, insomnia, dizziness, anxiety

CV: hypotension, vein discoloration and distention, nonsustained tachycardia, bradycardia

GI: constipation, diarrhea, abdominal pain, anorexia

GU: glycosuria

Metabolic: fluctuating electrolyte levels, hyperglycemia, metabolic acidosis, hyperkalemia

Musculoskeletal: joint pain

Other: fever, flulike symptoms

Interactions

Drug-diagnostic tests: Alanine aminotransferase, aspartate aminotransferase, bilirubin, blood and urine glucose, potassium: increased levels

Patient monitoring

• Monitor vital signs and ECG. Watch closely for tachycardia, bradycardia, and hypotension.
• Watch electrolyte levels for fluctuations (especially hyperkalemia and metabolic acidosis).
• Evaluate temperature. Stay alert for flulike symptoms.
• Closely monitor blood and urine glucose levels in diabetic patients. Stay alert for hyperglycemia.

Patient teaching

• Explain that drug helps prevent nausea and vomiting caused by chemotherapy.
• Teach patient to recognize and report signs and symptoms of hyperkalemia and metabolic acidosis.
• Advise patient to report flulike symptoms.
• Instruct diabetic patient to closely watch blood and urine glucose levels.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.