obiltoxaximab

General

Pronunciation:
oh-bil-tox-ax-i-mab

Trade Name(s)

  • Anthim

Ther. Class.
antidotes

Pharm. Class.
monoclonal anti-toxins

Indications

  • Treatment of inhalational anthrax in combination with anti-infective agents.
  • Prevention of inhalational anthrax when other agents cannot be used or are unavailable.

Action

A monoclonal anti-toxin that blocks the activity of toxin produced by Bacillus anthracis. The toxin is a primary cause of disease progression.

Therapeutic Effect(s):

Decreased morbidity and mortality associated with inhalational anthrax exposure and disease.

Pharmacokinetics

Absorption: IV administration results in complete bioavailability.

Distribution: Some tissue distribution.

Metabolism and Excretion: No renal clearance.

Half-life: Unknown.

TIME/ACTION PROFILE (levels)

ROUTEONSETPEAKDURATION
IVrapidend of infusionunknown

Contraindication/Precautions

Contraindicated in:

  • None noted.

Use Cautiously in:

  • OB: Effects in pregnant women are not known; use only if clearly needed;
  • Lactation: Use cautiously.

Adverse Reactions/Side Effects

CNS: headache

Derm: pruritus

Resp: cough, upper respiratory tract infection

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), injection site reactions

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

None noted.

Route/Dosage

IV (Adults and Children) >40 kg) 16 mg/kg single dose.

IV (Adults) ≤40 kg) 24 mg/kg single dose.

IV (Children 16–40 kg) 24 mg/kg single dose.

IV (Children ≤15 kg) 32 mg/kg single dose.

Availability

Solution for IV infusion (requires further dilution): 100 mg/mL

Assessment

  • Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing, urticaria, cough, dysphonia, throat irritation, dizziness, dyspnea, chest discomfort). Discontinue drug and notify health care professional immediately if these problems occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.

Potential Diagnoses

Implementation

  • Pre-medicate with diphenhydramine prior to administering.

IV Administration

  • Keep vial in carton to protect from light before preparing. Solution is clear to opalescent, colorless to pale yellow to pale brownish yellow, may contain few translucent-to-white proteinaceous particulates; do not administer solutions that are discolored or contain particulate matter.
  • Adults: Diluent: Dilute in 250 mL 0.9% NaCl. Invert to mix; do not shake. Solution is stable for up to 8 hrs at room temperature.Concentration: 100 mg/mL.Children and Adults weighing <40 kg: Diluent: Dilute in 100 mL or 250 mL of 0.9% NaCl. Invert to mix; do not shake. Solution is stable for up to 8 hrs at room temperature.Concentration: 100 mg/mL.Syringe for infusion: Diluent: Dilute dose in 0.9% NaCl.Concentration: 100 mg/mL.Administer immediately; do not store solution in syringe.
  • Rate:Infuse through a 0.22 micron inline filter. Flush line with 0.9% NaCl and end of infusion. For adults, infuse over 90 min at a rate of 167 mL/hr. For children and adults weighing >15 kg–40 kg, infuse at a rate of 167 mL/hr for 250 mL or 67 mL/hr for 100 mL infusion. For children ≤15 kg, infuse 100 mL at a rate of 67 mL/hr; 50 mL at 33.3 mL/hr; 25 mL at 17 mL/hr; 20 mL at 13.3 mL/hr; 15 mL at 10 mL/hr; and 7 mL at 4.7 mL/hr.

Patient/Family Teaching

  • Explain purpose of medication to patient.
  • Instruct patient to notify health care professional immediately if signs and symptoms of hypersensitivity reaction occur.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

Decreased morbidity and mortality associated with inhalational anthrax exposure and disease.

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