pegaptanib

(redirected from Pegabtanib)

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 ?
Treatment options have evolved from standard laser treatment in the mid-1980s, to photodynamic therapy (which combined a low-power laser with drug therapy) in the mid-to-late 1990s, to the December 2004 release of pegabtanib sodium injections (Macugen), which help stabilize vision loss in approximately 65 percent of patients but improve vision in only about 17 percent.