Dornase alfa recombinant
Dornase alfa recombinant (Pulmozyme)
Dornase Alfa Recombinant
( DOR-nace AL-fah)
Pregnancy Category: B Pulmozyme (Rx)

Classification: Drug for cystic fibrosis

Action/Kinetics: This drug is a highly purified solution of recombinant human deoxyribonuclease I (rhDNase), an enzyme that selectively cleaves DNA. It is produced by genetically engineered Chinese hamster ovary cells that contain DNA encoded for the native human protein, deoxyribonuclease (DNase). The amino acid sequence is identical to that of the native human enzyme. Cystic fibrosis (CF) clients have viscous purulent secretions in the airways that contribute to reduced pulmonary function and worsening of infection. These secretions contain high concentrations of extracellular DNA released by degenerating leukocytes that accumulate as a result of infection. Dornase alfa hydrolyzes the DNA in sputum of CF clients, thereby reducing sputum viscoelasticity and reducing infections.

Uses: In CF clients in conjunction with standard therapy to decrease the frequency of respiratory infections that require parenteral antibiotics and to improve pulmonary function.

Contraindications: Known sensitivity to dornase alfa or products from Chinese hamster ovary cells.

Special Concerns: Safety and effectiveness of daily use have not been demonstrated in clients with forced vital capacity (FVC) of less than 40% of predicted, or for longer than 12 months. Use with caution during lactation.

Side Effects: Respiratory: Pharyngitis, voice alteration, and laryngitis are the most common. Also, apnea bronchiectasis, bronchitis, change in sputum, cough increase, dyspnea, hemoptysis, lung function decrease, nasal polyps, pneumonia, pneumothorax, rhinitis, sinusitis, sputum increase, wheezing. Body as a whole: Abdominal pain, asthenia, fever, flu syndrome, malaise, sepsis, weight loss. GI: Intestinal obstruction, gall bladder disease, liver disease, pancreatic disease. Miscellaneous: Rash, urticaria, chest pain, conjunctivitis, diabetes mellitus, hypoxia.

How Supplied: Solution: 2.5 mg/2.5 mL

Dosage
?Inhalation Solution Cystic fibrosis.
One 2.5-mg single-dose ampule inhaled once daily using a recommended nebulizer (see what follows). Older clients and clients with baseline FVC above 85% may benefit from twice daily dosing.