Interferons, Alpha

INTRODUCTION

Indications

Peginterferon alpha-2a: Treatment of: Chronic hepatitis C (alone or with ribavirin), Chronic hepatitis B. Interferon alpha-2b: Treatment of: Hairy cell leukemia, Malignant melanoma, AIDS-related Kaposi’s sarcoma, Condylomata acuminata (intralesional), Chronic hepatitis B, Chronic hepatitis C (with oral ribavirin) which has relapsed following previous treatment with interferon alone, Follicular non-Hodgkin’s lymphoma. Peginterferon alpha-2b: Chronic hepatitis C (alone or with ribavirin). Interferon alpha-n3: Treatment of condylomata acuminata (intralesional).

Action

Interferons are proteins capable of modifying the immune response and have antiproliferative action against tumor cells. Interferon alpha-2b is produced by recombinant DNA techniques, peginterferon is a “pegylated” formulation of interferon alpha-2b formulated to have a longer duration of action; interferon alpha-n3 is from pooled human leukocytes. Interferons also have antiviral activity. Therapeutic Effects: Antineoplastic, antiviral, and antiproliferative activities. Decreased progression of hepatic damage (for patients with hepatitis).

Adverse Reactions/Side Effects

All are more prominent with SC, IV, or IM administration

CNS: NEUROPSYCHIATRIC DISORDERS, confusion, depression, dizziness, fatigue, headache, insomnia, irritability, anxiety. EENT: blurred vision, nose bleeds, rhinitis. CV: ISCHEMIC DISORDERS, arrhythmias, chest pain, edema. GI: COLITIS, PANCREATITIS, anorexia, abdominal pain, diarrhea, dry mouth, nausea, taste disorder, vomiting, weight loss, drug-induced hepatitis, flatulence. Derm: alopecia, dry skin, pruritus, rash, sweating. Endo: thyroid disorders. Hemat: LEUKOPENIA, THROMBOCYTOPENIA, anemia, hemolytic anemia (with ribavirin). MS: arthralgia, myalgia, leg cramps. Neuro: paresthesia. Resp: cough, dyspnea. Local: injection site reactions. Misc: AUTOIMMUNE DISORDERS, INFECTIOUS DISORDERS, allergic reactions, including anaphylaxis, chills, fever, flu-like syndrome.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Continually monitor for signs of ischemic disorders, including MI (sudden chest pain, pain radiating into the arm or jaw, shortness of breath, dizziness, sweating, anxiety, nausea), stroke (sudden severe headache, confusion, nausea, vomiting, paralysis, numbness, speech problems, visual disturbances), or peripheral ischemia (extreme coldness in the hands and feet, cyanosis, muscle cramping). Seek immediate medical assistance if patient develops these signs.

• Be alert for signs of colitis (diarrhea, abdominal pain, cramps, nausea, fecal incontinence) and pancreatitis (upper abdominal pain especially after eating, indigestion, weight loss, oily stools). Notify physician immediately of these signs.

• Monitor signs of leukopenia (fever, sore throat, signs of infection), thrombocytopenia (bruising, nose bleeds, bleeding gums), or unusual weakness and fatigue that might be due to anemias or other blood dyscrasias. Report these signs to the physician immediately.

• Be alert for signs of autoimmune reactions and infectious ...