recombinant

(redirected from recombinants)
Also found in: Dictionary, Thesaurus, Encyclopedia.
Related to recombinants: recombinant vaccine, Recombinant proteins

recombinant

 [re-kom´bĭ-nant]
1. the new entity (e.g., gene, protein, cell, individual) that results from genetic recombination.
2. pertaining or relating to such an entity.
recombinant DNA technology the process of taking a gene from one organism and inserting it into the DNA of another; called also gene splicing. One commonly used technique involves the insertion of a new fragment of DNA that codes for a specific protein such as human insulin into a bacterium such as Escherichia coli. The gene is first inserted into a plasmid, a self-replicating ring of DNA involved in the transfer of genes between bacteria. The plasmid is cut at a specific site by using a special cutting enzyme called a restriction endonuclease. The same procedure is used to cut out a segment of DNA from another organism, for example, the gene for human insulin. This fragment of insulin DNA is inserted into the plasmid and then sealed into place by an annealing enzyme. The altered plasmid is then taken up by bacterium and incorporated into the genome. When the bacterial cells divide they pass on the new information to the next generation. This produces clones of bacteria that produce large quantities of the new protein, in this example, insulin.



This process has had great impact in the field of medicine. It has revolutionized the manufacture of pharmaceutical products, where it is used to manufacture a variety of proteins used in the treatment of disease, including hormones, vaccines, and interferons.

alteplase (tissue plasminogen activator, recombinant)

Actilyse (UK), Activase, Activase rt-PA (CA), Cathflo Activase

Pharmacologic class: Plasminogen activator

Therapeutic class: Thrombolytic

Pregnancy risk category C

Action

Converts plasminogen to plasmin, which in turn breaks down fibrin and fibrinogen, thereby dissolving thrombus

Availability

Injection: 2-mg single-patient vials; 50-mg, 100-mg vials

Indications and dosages

Lysis of thrombi obstructing coronary arteries in acute myocardial infarction (MI)

3-hour infusion-

Adults: 100 mg I.V. over 3 hours as follows: 60 mg over first hour (give 6 to 10 mg as bolus over first 1 to 2 minutes), then 20 mg I.V. over second hour, then 20 mg I.V. over third hour

Adults weighing less than 65 kg (143 lb): 1.25 mg/kg I.V. in divided doses over 3 hours, not to exceed 100 mg Accelerated infusion-

Adults weighing more than 67 kg (147 lb): Give total dosage of 100 mg as follows: 15 mg I.V. bolus over 1 to 2 minutes, then 50 mg I.V. over next 30 minutes, then 35 mg I.V. over next 60 minutes.

Adults weighing 67 kg (147 lb) or less: 15 mg I.V. bolus over 1 to 2 minutes, followed by 0.75 mg/kg I.V. over next 30 minutes (not to exceed 50 mg), followed by 0.5 mg/kg I.V. over next hour, not to exceed 35 mg

Acute ischemic cerebrovascular accident (CVA)

Adults: 0.9 mg/kg I.V. over 1 hour, to a maximum dosage of 90 mg, with 10% of total dosage given as I.V. bolus within first minute

Acute massive pulmonary embolism

Adults: 100 mg I.V. over 2 hours, followed by heparin

Restoration of function of central venous access device

Adults weighing 30 kg (66 lb) or more:Cathflo Activase-2 mg/2-ml concentration instilled in dysfunctional catheter. If catheter function isn't restored in 120 minutes after first dose, may give second dose.

Adults weighing 10 kg (22 lb) to less than 30 kg:Cathflo Activase-Use 110% of catheter lumen volume not to exceed 2 mg/2-ml concentration instilled in dysfunctional catheter. If catheter function isn't restored in 120 minutes after first dose, may give second dose.

Off-label uses

• Small-vessel occlusion by microthrombi
• Peripheral arterial thromboembolism

Contraindications

• Hypersensitivity to drug or its components (Cathflo Activase)
• Seizures, stroke, aneurysm, intracranial neoplasm, bleeding diathesis

Precautions

Use cautiously in:
• hypersensitivity to anistreplase or streptokinase
• GI or genitourinary bleeding, ophthalmic hemorrhage, organ biopsy, severe hepatic or renal disease
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

Be aware that intracranial hemorrhage must be ruled out before therapy begins.

To treat acute ischemic CVA, give within 3 hours of initial signs or symptoms.

If uncontrolled bleeding occurs, stop infusion and notify prescriber immediately.
• Give I.V. only, using controlled-infusion pump.
• Reconstitute with unpreserved sterile water for injection. May be further diluted with normal saline solution or D5W.

Adverse reactions

CNS: cerebral hemorrhage, cerebral edema, CVA (with accelerated infusion)

CV: hypotension, bradycardia, recurrent ischemia, pericardial effusion, pericarditis, mitral regurgitation, electromechanical dissociation, arrhythmias, cardiogenic shock, heart failure, cardiac arrest, cardiac tamponade, myocardial rupture, embolization, venous thrombosis

GI: nausea, vomiting, GI bleeding

GU: GU tract bleeding

Hematologic: spontaneous bleeding, bone marrow depression

Musculoskeletal: musculoskeletal pain

Respiratory: pulmonary edema

Skin: bruising, flushing

Other: fever, edema, phlebitis or bleeding at I.V. site, hypersensitivity reaction (including rash, anaphylactic reaction, laryngeal edema), sepsis

Interactions

Drug-drug.Aspirin, drugs affecting platelet activity (such as abciximab, heparin, dipyridamole, oral anticoagulants, vitamin K antagonists): increased risk of bleeding

Drug-diagnostic tests.Blood urea nitrogen: elevated level

Patient monitoring

• Monitor vital signs, ECG, and neurologic status.
• Maintain strict bed rest.
• Watch for signs and symptoms of bleeding tendency and hemorrhage.
• Monitor patient on Cathflo Activase for GI bleeding, venous thrombosis, and sepsis.
• Evaluate results of clotting studies.

Patient teaching

• As appropriate, explain therapy and monitoring to patient and family.


coagulation factor VIIa (recombinant)

NovoSeven RT

Pharmacologic class: Coagulation factor VIIa

Therapeutic class: Antihemophilic agent

Pregnancy risk category C

FDA Box Warning

• Arterial and venous thrombotic and thromboembolic events following administration of NovoSeven RT have been reported during postmarketing surveillance. Clinical studies have shown an increased risk of arterial thromboembolic adverse events with NovoSeven RT when administered outside the current approved indications. Fatal and nonfatal thrombotic events have been reported.

• Discuss the risks and explain the signs and symptoms of thrombotic and thromboembolic events to patients who will receive NovoSeven RT.

• Monitor patients for signs or symptoms of activation of the coagulation system and for thrombosis.

• Safety and efficacy of NovoSeven RT haven't been established outside the approved indications.

Action

Promotes hemostasis by activating intrinsic pathway of coagulation cascade to form fibrin

Availability

Lyophilized powder for injection: 1 mg/vial, 2 mg/vial, 5 mg/vial

Indications and dosages

Bleeding episodes in patients with hemophilia A or B who have inhibitors to factor VIII or IX and in patients with acquired hemophilia

Adults: For hemostatic dosing, 90 mcg/kg I.V. bolus q 2 hours until hemostasis occurs or therapy is deemed ineffective. For posthemostatic dosing, appropriate dosing duration hasn't been determined. For severe bleeds, continue dosing at 3- to 6-hour intervals after hemostasis is achieved, to maintain hemostatic plug.

Prevention of bleeding in surgical interventions or invasive procedures in patients with hemophilia A or B who have inhibitors to factor VIII or IX and in patients with acquired hemophilia

Adults: Initially, 90 mcg/kg I.V. immediately before intervention and repeated at 2-hour intervals for duration of surgery. For minor surgery, administer postsurgical doses by I.V. bolus injection at 2-hour intervals for first 48 hours and then at 2- to 6-hour intervals until healing has occurred. For major surgery, administer postsurgical doses by I.V. injection at 2-hour intervals for 5 days, followed by 4-hour intervals until healing has occurred. Administer additional bolus doses, if required.

Bleeding episodes or prevention of bleeding in surgical intervention or invasive procedures in patients with congenital factor VII deficiency

Adults: 15 to 30 mcg/kg I.V. q 4 to 6 hours until hemostasis is achieved. Effective treatment has been achieved with dosages as low as 10 mcg/kg.

Bleeding episodes or surgery in patients with acquired hemophilia

Adults: 70 to 90 mcg/kg I.V., repeated q 2 to 3 hours until hemostasis is achieved

Contraindications

None

Precautions

Use cautiously in:
• hypersensitivity to drug, its components, or mouse, hamster, or bovine products
• prolonged use of drug
• concomitant use of activated or non-activated prothrombin complex concentrates (avoid use)
• patients with increased risk of thromboembolic complications (including advanced atherosclerotic disease, crush injury, septicemia, history of coronary heart disease, liver disease, disseminated intravascular coagulation, postoperative immobilization, elderly patients and neonates)
• pregnant or breastfeeding patients
• children.

Administration

• Monitor factor VII-deficient patients for prothrombin time and factor VII coagulant activity before administering drug.

Give by I.V. bolus only over 2 to 5 minutes, depending on dosage.
• Reconstitute only with specified volume of diluent supplied.

Don't mix with sterile water for injection or infusion solutions.

Don't inject diluent directly on the powder.
• Administer within 3 hours of reconstituting. If line needs to be flushed before or after administering drug, use normal saline solution.

Adverse reactions

CNS: headache,

cerebral artery occlusion, cerebrovascular accident

CV: hypertension, hypotension, bradycardia, angina, superficial thrombophlebitis, thrombophlebitis, deep vein thrombosis, coagulation disorder, disseminated intravascular coagulation (DIC), increased fibrinolysis, purpura

GI: nausea, vomiting

GU: renal dysfunction

Hematologic: purpura, hemorrhage, hemarthrosis, disseminated intravascular coagulation, coagulation disorders, decreased fibrinogen plasma, thrombosis

Musculoskeletal: arthrosis, arthralgia

Respiratory: pneumonia, pulmonary embolism

Skin: pruritus, rash, urticaria

Other: fever, edema, pain, redness or reaction at injection site, hypersensitivity reaction

Interactions

Drug-drug.Activated prothrombin complex concentrates, prothrombin complex concentrates: risk of potential interaction (though not evaluated)

Patient monitoring

Monitor for signs and symptoms of coagulation activation or thrombosis. If DIC or thrombosis is confirmed, reduce dosage or discontinue drug, depending on patient's symptoms.
• Monitor factor VII-deficient patients for prothrombin time and factor VII coagulant activity before and after administering drug. If factor VIIa activity fails to reach expected level, prothrombin time isn't corrected, or bleeding isn't controlled after treatment with recommended dosages, antibody formation may be suspected and analysis for antibodies should be performed.
• Be aware that laboratory coagulation parameters may be used as adjunct to clinical evaluation of hemostasis to monitor drug efficacy and treatment schedule. However, these parameters lack direct correlation with achievement of hemostasis.
• Monitor renal function tests.

Patient teaching

Instruct patient to immediately report signs and symptoms of hypersensitivity reactions (including hives, urticaria, chest tightness, or wheezing) and thrombosis (including new-onset swelling and pain in limbs or abdomen, new-onset chest pain, shortness of breath, loss of sensation, or altered consciousness or speech).
• Instruct patient to report swelling, pain, burning, or itching at infusion site.
• Tell patient to inform prescriber if she's pregnant or intends to become pregnant.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.


teriparatide (recombinant)

Forsteo, ForteoAxiron, Androderm, AndroGel, Andropatch, Fortesta, Striant, Testim, Testogel, Testopel Pellets, Testos

Pharmacologic class: Biosynthetic fragment of human parathyroid hormone

Therapeutic class: Parathyroid hormone

Pregnancy risk category C

FDA Box Warning

In male and female rats, drug increased incidence of osteosarcoma (malignant bone tumor). Because of uncertain relevance of this finding to humans, use drug only in patients for whom potential benefits outweigh potential risk. Don't administer to patient at increased baseline risk for osteosarcoma.

Action

Stimulates new bone growth by binding to specific high-affinity cell-surface receptors

Availability

Injection: Multidose prefilled delivery device (pen) with 28 daily doses of 20 mcg/dose (600 mcg/2.4 ml)

Indications and dosages

Osteoporosis in patients at high risk for bone fracture

Adults: 20 mcg/day subcutaneously for up to 2 years

Contraindications

• Hypersensitivity to drug
• Conditions that increase osteosarcoma risk (such as Paget's disease, unexplained alkaline phosphatase elevation, open epiphyses, skeletal radiation therapy)
• Bone cancer metastases or history of bone cancer
• Metabolic bone disease other than osteoporosis
• Hypercalcemia

Precautions

Use cautiously in:
• urolithiasis, hypotension
• concurrent use of cardiac glycosides
• pregnant or breastfeeding patients.

Administration

• Inject subcutaneously into thigh or abdominal wall, with patient lying down.
• Know that prefilled injection pen delivers 20 mcg of drug per actuation and may be reused for up to 28 days after first injection. Discard pen in protected container after 28 days, even if it's not empty.

Adverse reactions

CNS: dizziness, headache, insomnia, depression, vertigo, asthenia

CV: hypertension, angina, syncope

EENT: rhinitis, pharyngitis

GI: nausea, vomiting, diarrhea, dyspepsia, anorexia

Metabolic: hyperuricemia

Musculoskeletal: joint pain, cramps

Respiratory: cough, dyspnea, pneumonia

Skin: rash, sweating

Other: pain

Interactions

Drug-drug.Digoxin: increased digoxin toxicity

Drug-diagnostic tests.Calcium: increased level

Patient monitoring

• Monitor respiratory and neurologic status and assess patient's mood.
• Monitor bone mineral density tests and calcium level.

Patient teaching

• Instruct patient to promptly report such adverse reactions as cough and difficulty breathing.
• Tell patient that prefilled injection pen delivers 20 mcg of drug per actuation. Inform him that he may reuse it for up to 28 days after first injection, and should then discard it in appropriate receptacle, even if it's not empty.
• Advise patient to establish effective bedtime routine to minimize insomnia.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects strength and balance.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


testosterone

Axiron, Androderm, AndroGel, Andropatch, Fortesta, Striant, Testim, Testogel, Testopel Pellets, Testos


re·com·bi·nant

(rē-kom'bi-nănt),
1. A cell or organism that has received genes from different parental strains.
2. Pertaining to or denoting such organisms.
3. In linkage analysis, the change of coupling phase at two loci during meiosis. If two syntenic, nonallelic genes are inherited from the same parent, they must be in coupling. An offspring that inherits only one of them is recombinant and indicates an odd number of cross-overs between the loci; an offspring that inherits neither or both are nonrecombinant and may indicate an even number of cross-overs or none.

recombinant

/re·com·bi·nant/ (re-kom´bĭ-nant)
1. the new entity (e.g., gene, protein, cell, individual) that results from genetic recombination.
2. pertaining or relating to such an entity. See also under DNA.

recombinant

(rē-kŏm′bə-nənt)
n.
1. An organism, cell, or virus in which genetic recombination has taken place.
2. Material produced by genetic engineering.
adj.
1. Formed by or showing recombination: a recombinant chromosome.
2. Of or relating to recombinant DNA: recombinant fragments; recombinant technology.

recombinant

[rēkom′binənt]
Etymology: L, re, again, combinare, to combine
1 n, a molecule, a cell, or an organism that results from the recombination of genes, regardless of whether naturally or artificially induced.
2 adj, pertaining to such a molecule, a cell, or an organism. See also recombinant DNA.

recombinant

adjective Referring to a structural rearrangement or shuffling of genetic material that:
(1) Occurs normally during meiosis; or
(2) Is deliberately generated under controlled experimental conditions, as in recombinant DNA.
 
noun An organism with a combination of alleles from either parent due to crossing over or independent assortment of chromosomes during meiosis.

recombinant

adjective Referring to a structural rearrangement or 'shuffling' of genetic material that
1. Occurs normally during meiosis or.
2. Is deliberately generated under controlled experimental conditions, as in recombinant DNA noun An organism with a combination of alleles from either parent due to crossing over or independent assortment of chromosomes during meiosis.

re·com·bi·nant

(rē-kom'bi-nănt)
1. A progeny that has received chromosomal parts from different parental strains as a result of uncorrected crossing over.
2. Pertaining to such organisms.
3. In linkage analysis, the change of coupling phase at two loci during meiosis. If two syntenic, nonallelic genes are inherited from the same parent, they must be in coupling.

recombinant

Pertaining to an organism, chromosome or segment of DNA produced by genetic material from more than one source.

re·com·bi·nant

(rē-kom'bi-nănt)
1. Cell or organism that has received genes from different parental strains.
2. Pertaining to or denoting such organisms.

recombinant

1. the new cell or individual that derives some of its genetic material from one parent and some from another, genetically different parent.
2. pertaining or relating to such cells or individuals.

recombinant DNA technology
a mixture of technologies developed in the 1970s that include (a) specific cleavage of DNA by restriction endonucleases; (b) nucleic acid hybridization which makes it possible to identify specific sequences of DNA or RNA; (c) DNA cloning whereby a specific DNA fragment is integrated (spliced) into a rapidly replicating, high yielding genetic element (plasmid or virus) so that it can be amplified in bacteria or yeast; (d) DNA sequencing of the nucleotides in a cloned DNA fragment.
References in periodicals archive ?
The recombination breakpoint of putative recombinant strains was determined by using 2 methods: the maximum chi-squared method (20) and Simplot (version 2.
We previously reported that the closest matching strain based on sequence searches using a 298-bp fragment of the RdRp region was the Arg320/95/AR strain (17), a known recombinant NoV (12) (Table).
The distinct segregation into 2 different phylogenetic positions strongly suggested that this virus was a recombinant NoV.
However, the polymerase did not cluster with Hawaii virus but with the second recombinant that we identified, namely NoV/Sydney C14/02/AU, and these isolates do not group with any known genotype in the polymerase region.
Relationships between Regions of Recombinant NoV GII
Only 1 recombinant genogroup I strain has been identified, the Japanese isolate WUGI (10).

Full browser ?