Managing infusion-associated reactions (IARs)
During infusions, monitor the patient for signs that may indicate an IAR:
- Increase or decrease in heart rate
- Increase or decrease in respiratory rate
- Decrease in oxygen saturation (pulse oximetry)
- Increase or decrease in body temperature
Mild symptoms may progress rapidly to more severe symptoms if the patient is left untreated. Therefore, monitor patients throughout the infusion, especially when the rate of infusion is increased.
If an IAR occurs
- Stop the infusion promptly
- Assess and appropriately manage the patient’s symptoms
- Consider administering additional antihistamines, antipyretics, and possibly, prophylactic corticosteroids
- If symptoms subside, consider restarting the infusion at a slower rate
- Subsequent infusions may be managed with a slower rate (infusion time can be extended to 20 hours if IARs occur), additional prophylactic, antihistamines, antipyretics and possibly, prophylactic corticosteroids
- The physician should evaluate risk and benefits of re-administering NAGLAZYME®(galsulfase) following a severe hypersensitivity or anaphylactic reaction
- Caution should be exercised when considering epinephrine use in patients with MPS VI, due to the increased prevalence of coronary artery disease in this patient population
An IAR might not occur until multiple infusions have been given
In clinical studies, the first IAR occurred as late as 55 weeks. Therefore it is important that:
- A Physician be available or accessible by phone or pager at time of infusion
- Nurses monitor the patient closely and observe for IAR symptoms
- Emergency procedures be in place in the event a severe IAR occurs
- Patients and/or parents are educated and encouraged to promptly report IAR symptoms. This is especially important for parents of younger patients who may not be able to report IAR symptoms
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