ocriplasmin

ocriplasmin

(ok-plas-min) ocriplasmin,

Jetrea

(trade name)

Classification

Therapeutic: ocular agents
Pharmacologic: enzymes
Pregnancy Category: C

Indications

Symptomatic treatment of vitreomacular adhesion (VMA).

Action

A proteolytic enzyme that dissolves the protein matrix present in vitreomacular adhesions.

Therapeutic effects

Dissolution of vitreomacular adhesion with improved vision.

Pharmacokinetics

Absorption: Minimal absorptionDistribution: Action is primarily localMetabolism and Excretion: Rapidly degraded following administrationHalf-life: Unknown.

Time/action profile (VMA resolution)

ROUTEONSETPEAKDURATION
Intravitrealwithin 1 wk3 wk6 mos or more

Contraindications/Precautions

Contraindicated in: None noted.Use Cautiously in: Lactation: Effects are not know, use caution Obstetric: Use during pregnancy only if clearly needed Pediatric: Safe and effective use in children has not been established

Adverse Reactions/Side Effects

May be due to procedure

Ear, Eye, Nose, Throat

  • blurred vision (most frequent)
  • conjunctival hemorrhage (most frequent)
  • ↓ visual acuity (most frequent)
  • eye pain (most frequent)
  • macular hole (most frequent)
  • vitreous floaters (most frequent)
  • retinal edema (most frequent)
  • anterior chamber cell
  • cataract
  • conjunctival hyperemia
  • dry eye
  • dyschromatopsia (yellow vision)
  • ↑ intraocular pressure
  • intraocular inflammation/infection
  • intraocular hemorrhage
  • iritis
  • lens subluxation
  • macular edema
  • metamorphopsia (distorted vision)
  • photophobia
  • photopsia (perceived light flashes)
  • retinal degeneration
  • retinal detachment
  • vitreous detachment

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

Intravitreal (Adults) 0.125 mg injected as a single dose

Availability

Solution for intravitreal injection: 0.5 mg/0.2 mL

Nursing implications

Nursing assessment

  • Monitor for elevation in intraocular pressure following injection.
  • Monitor visual acuity periodically following injection; may lead to decrease in vision.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Ocriplasmin must be administered by a qualified physician.
  • Intravitreal: Remove vial from freezer and allow to thaw for few min at room temperature. Add 0.2 mL of preservative free 0.9% NaCl. Swirl gently until mixed. Solution is clear and colorless without particles; do not administer solutions that are discolored or contain particulate matter. Withdraw all solution from vial with a 19 gauge needle. Replace needle with 30 gauge needle and expel excess air and solution to 0.1 mL. Discard unused solution. Administer adequate anesthesia and a broad spectrum antibiotic as per protocol. Intravitreal injection is done via aseptic technique. Repeat administration in same eye is not recommended.
    • Wait 7 days before treating other eye if necessary.

Patient/Family Teaching

  • Explain procedure for intravitreal injection to patient.
  • Advise patient to notify health care professional immediately if signs and symptoms of intraocular inflammation/infection (eye redness, sensitivity to light, eye pain, change in vision) occurs.
  • May cause visual changes. Advise patient to avoid driving and other activities requiring good vision until response to medication is known.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Improved vision in patients with vitreomacular adhesions.