pegaptanib

(redirected from Macugen)

pegaptanib

(peg-apt-i-nib) ,

Macugen

(trade name)

Classification

Therapeutic: ocular agents
Pharmacologic: vascular endothelial growth factor antagonists
Pregnancy Category: B

Indications

Neovascular (wet) age-related macular degeneration.

Action

Acts as an antagonist of vascular endothelial growth factor (VEGF). VEGF may be responsible for the formation of incompetent, leaky blood vessels associated with macular degeneration.

Therapeutic effects

Decreased rate of loss of visual acuity.

Pharmacokinetics

Absorption: Slowly absorbed into systemic circulation after intravitreous administration.
Distribution: Unknown.
Metabolism and Excretion: Metabolized by exo- and endonucleases.
Half-life: 10 days (plasma).

Time/action profile

ROUTEONSETPEAKDURATION
Intravitrealunknownunknown6 wk

Contraindications/Precautions

Contraindicated in: Ocular/periocular infections.
Use Cautiously in: Obstetric: Use only if maternal benefit outweighs fetal risk; Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Ear, Eye, Nose, Throat

  • cataract
  • blurred vision
  • conjunctival bleeding
  • irritation/pain
  • ↑ intraocular pressure
  • ocular inflammation
  • infection (rare)
  • retinal detachment (rare)
  • traumatic cataract formation (rare)

Miscellaneous

  • Anaphylaxis
  • angioedema

Interactions

Drug-Drug interaction

None known.

Route/Dosage

Intravitreal (Adults) 0.3 mg every 6 wk.

Availability

Solution for intraviteous injection: 0.3 mg/mL in 1-mL single use glass syringes

Nursing implications

Nursing assessment

  • Assess eye for signs of infection frequently during week following injection.
  • Check perfusion of optic nerve head immediately after injection, use tonometry to measure intraocular pressure within 30 min following the injection, and biomicroscopy between 2 and 7 days following injection. Increases in intraocular pressure have been seen within 30 min of injection.

Potential Nursing Diagnoses

Disturbed sensory perception (Indications)

Implementation

  • Do not administer solutions that are discolored or contain particulate matter. Attach threaded plastic threader rod to the rubber stopper inside barrel of syringe. Do not pull back on plunger.
    • Adequate analgesia and a broad-spectrum antibiotic should be given prior to injection.
  • Intravitreal: For ophthalmic intravitreal injection only.

Patient/Family Teaching

  • Advise patient to notify ophthalmologist immediately if eye becomes red, sensitive to light, painful, or develops a change in vision.

Evaluation/Desired Outcomes

  • Slowing of vision loss.

pegaptanib

a miscellaneous ophthalmic agent that binds to vascular endothelial growth factor, thereby inhibiting angiogenesis.
indications This drug is used in the treatment of neovascular age-related macular degeneration. It may be used alone or with photodynamic therapy.
contraindications Ocular or periocular infections and known hypersensitivity to this drug prohibit its use.
adverse effects Adverse effects of this drug include retinal detachment and traumatic cataract. Common side effects include anterior chamber inflammation, blurred vision, conjunctival hemorrhage, corneal edema, cataract, eye discharge, eye pain, increased intraocular pressure, punctuate keratitis, reduced visual acuity, vitreous floaters, vitreous opacities, blepharitis, conjunctivitis, and photophobia.

pegaptanib

An anti-vascular endothelial growth factor agent that has been found helpful in the treatment of neovascular age-related macular degeneration. A brand name is Macugen.
References in periodicals archive ?
Primary Care Trusts across Merseyside have agreed to automatically fund Macugen, which costs pounds 8,000 a year, and Lucentis, which costs pounds 18,000 a year, to help beat Age-related Macular Degeneration (AMD).
Elsewhere in the UK there is a postcode lottery as to whether patients are prescribed the sight-saving drugs Macugen and Lucentis.
Macugen works in a different, selective way to the sole recommended anti-VEGF treatment ranibizumab; like it, Macugen is licensed to treat all forms of wet AMD,(1) and offers the potential to preserve the sight of those AMD patients for whom ranibizumab is clinically inappropriate.
The National Institute for Health and Clinical Excellence (Nice) has come under intense pressure to approve the drugs Lucentis (ranibizumab) and Macugen (pegaptanib) for use on the NHS.
Medics are using the Macugen jabs to combat macular degeneration, one of the common conditions that causes blindness.
Another newly approved drug is Macugen, an intraocular Injectable for treatment of wet age-related macular degeneration.
The bad news is that it has not yet been cleared by Nice, the body which gives clearance to new drugs, and some primary care trusts are alleged to be hiding behind Nice and refusing to supply Macugen on the grounds it is not yet approved.
The bad news is that it has not yet been cleared by NICE, the body which gives clearance to new drugs, and some PCTs are alleged to be hiding behind NICE and refusing to supply Macugen on the grounds that it is not yet approved.
European Commission Approves Macugen for Treatment of All Types of Wet
Carlsbad, CA) has sold a portion of its royalty rights in Macugen (pegaptanib sodium injection) to Drug Royalty USA, Inc.
Another medication in phase III trials is Macugen from Eyetech and Pfizer.
Macugen (pegaptanib sodium)--developed by Pfizer, Inc.