short ragweed pollen allegen extract

short ragweed pollen allegen extract

Ragwitek

Indications

Action

Pharmacokinetics

Time/action profile (decrease in symptoms/need for medications)

Contraindications/Precautions

Adverse Reactions/Side Effects

Gastrointestinal

• oral paresthesia (most frequent)
• oral prutitus (most frequent)
• tongue pruritus
• eosinophilic esophagitis
• mouth edema

Ear, Eye, Nose, Throat

• throat irritation (most frequent)
• ear pruritus (most frequent)

Respiratory

• larygopharyngeal swelling (life-threatening)
• oropharyngeal pain

Miscellaneous

• allergic reactions including anaphylaxis

Interactions

Drug-Drug interaction

Route/Dosage

Availability

Nursing implications

Nursing assessment

• Assess for signs and symptoms of allergy (sneezing; runny or itchy nose; nasal congestion; itchy, watery eyes) before and periodically during therapy.
• Monitor for signs and symptoms of allergic reactions (trouble breathing, throat tightness or swelling, trouble swallowing or speaking, dizziness or fainting, rapid or weak heartbeat, severe stomach cramps or pain, vomiting, diarrhea, severe flushing or itching) for at least 30 min after initial dose. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction. Discontinue therapy of severe allergic reaction occurs. If persistent or escalating reactions occur, re-evaluate therapy and consider discontinuation.
• Monitor for signs and symptoms of eosinophilic esophagitis (severe or persistent gastro-esophageal symptoms, dysphagia, chest pain). Discontinue therapy and consider diagnosis if symptoms occur.
• Monitor for signs and symptoms of asthma attack (wheezing, coughing, dyspnea) before administering. Withhold if patient experiencing acute asthma exacerbation. If recurrent asthma exacerbations occur, consider discontinuation of therapy.
• Assess for oral inflammation (oral lichen planus, mouth ulcers, thrush) prior to administration. Allow healing before administration.

Potential Nursing Diagnoses

Implementation

• Therapy should be started at least 12 wks prior to onset and throughout ragweed pollen season. Administer first dose in health care setting and monitor patient for allergic reactions for at least 30 min. If no reactions occur, patient may administer subsequent doses at home.
• Sublingual: Remove tablet from blister just prior to dosing. Immediately place tablet under tongue until complete dissolution for at least 1 min before swallowing. Wash hands after handling tablet.

Patient/Family Teaching

• Instruct patient in correct method of taking Ragwitek; avoid swallowing tablet until dissolved. Avoid food or beverage for 5 min after dissolution of tablet. If dose is missed, omit and take next scheduled dose next day; do not double doses. If more than 1 dose is missed, notify health care professional before restarting. Explain to patient that therapy does not give immediate relief of allergy symptoms. Instruct patient to read Medication Guide before starting therapy and with each Rx refill in case of changes.
• Instruct patient in how and when to use autoinjectable epinephrine and to seek immediate medical care if used.
• Advise patient to stop therapy notify health care professional if signs and symptoms of allergic reactions, asthma attack, oral inflammation, or eosinophilic esophagitis occur.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
• Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

• Decreased symptoms or allergic rhinitis and/or conjunctivitis.