Dornase Alfa

( Recombinant Human Deoxyribonuclease ; DNase )

Pronunciation: DOR-nace AL-fuh
Class: Mucolytic

Trade Names

Pulmozyme
- Solution for inhalation 1 mg/mL

Pharmacology

Cleaves DNA released by neutrophils that are mobilized to respiratory tract in response to infection, reducing viscoelasticity of purulent lung secretions, increasing airflow, and decreasing risk of infection.

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Indications and Usage

Treatment of cystic fibrosis.

Contraindications

Hypersensitivity to Chinese hamster ovary cell products.

Dosage and Administration

Adults and Children older than 5 yr of age

Inhalation 2.5 mg once daily by oral inhalation via nebulizer; patients older than 21 yr of age and those with baseline forced vital capacity more than 85% benefit from 2.5 mg twice daily.

General Advice

  • Discard solution if cloudy or discolored.
  • Discard unused portions of ampules.
  • Do not dilute or mix drug with other drugs in nebulizer.

Storage/Stability

Keep refrigerated and protected from strong light. Storing at room temperature for less than 24 h does not adversely affect product.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Chest pain.

Dermatologic

Rash.

EENT

Conjunctivitis; sore throat; voice alterations; hoarseness.

Respiratory

Hoarseness; pharyngitis; laryngitis.

Precautions

Monitor

Perform auscultation to determine quality of breath sounds. Note characteristics of cough and sputum. Perform chest physiotherapy (percussion and postural drainage) as ordered.


Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy in children younger than 5 yr of age not established.

Secretions

Assess patient's ability to clear secretions. Provide assistance with coughing, positioning (semi-Fowler's or sitting upright) and suctioning. Provide hydration to liquefy secretions and replace fluids.

Patient Information

  • Teach patient to follow manufacturer's instructions on use and maintenance of nebulizer and compression system.
  • Instruct patient in proper administration and storage of drug.
  • Tell patient that drug may cause sore throat, voice alterations, or hoarseness, and to inform health care provider if these or any other symptoms become bothersome.
  • Inform patient that benefits of treatment may not become apparent for months.
  • Emphasize importance of avoiding contraction of respiratory infections.

Copyright © 2009 Wolters Kluwer Health.

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