Oprelvekin Neumega

Recombinant human IL-11 (oprelvekin) is a polypeptide of 177 amino acids. It differs from natural IL-11 due to lack of glycosylation and the amino-terminal proline residue. Oprelvekin is administered by subcutaneous injection, usually 6-24 h after chemotherapy, at a dose of 25-50 p,g/kg per day. The drug has a half-life of about 7h. It is used to stimulate bone marrow to induce platelet production in nonmyeloid malignancies in patients undergoing chemotherapy. The common side effects of oprelvekin include fluid retention, tachycardia, edema, nausea, vomiting, diarrhea, shortness of breath and mouth sores. Other side effects include rash at the injection site, blurred vision, paresthesias, headache, fever, cough and bone pain. Rarely, CLS may occur. 

IL-13 belongs to the same a-helix superfamily as IL-4, and their genes are located 12 kb apart on chromosome 5q31. It was originally identified for its effects on B 

It regulates mucus production, inflammation, fibrosis and tissue remodeling. IL-13 is a therapeutic target for a number of disease states including asthma, idiopathic pulmonary fibrosis, ulcerative colitis, cancer and others. Its signaling is mediated via IL-4 type 2 receptor. The receptor consists of IL-4Ra and IL-13Ral and IL-13Ra2 chains. 

IL-18 augments T- and NK-cell maturation, cytotoxicity and cytokine production. It stimulates TH differentiation, promotes secretion of TNF-a, IFN-y and GM-CSF and enhances NK cell cytotoxicity by increasing FasL expression. IL-8-mediated neutrophil chemotaxis is promoted by IL-18 via its effects on TNF-a and IFN-y, which are stimulatory in action. It plays an important role in maintaining synovial inflammation and inducing joint destruction in rheumatoid arthritis. In synovium of patients with rheumatoid arthritis, enhanced levels of TNF-a and IL-1 are associated with augmented expression of IL-18. 

IL-18 also induces IL-4, IL-10 and IL-13 production, increases IgE expression on B cells and in association with IL-2, it enhances stimulus-induced IL-4 production from TH2 cells. Bone marrow-derived basophils produce IL-4 and IL-13 in response to a stimulus from IL-18 and IL-3. IL-18 in combination with IL-12 induces IFN-y from dendritic cells and bone marrow-derived macrophages. Adhesion molecules, ICAM-1 and VCAM-1, are induced by this cytokine on synovial fibroblasts and endothelial cells. It inhibits osteoclast formation via its induction of GM-CSF from T cells. The receptors ofIL-18, IL-18Ra and IL-18R(3, share their signaling mechanisms via the IL-1R family. Toll-like receptors also share the downstream signaling pathway of IL-18 and are known to regulate IL-18 expression. 

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Filgrastim [G-CSF] (Neupogen) Oprelvekin (Neumega) Pegfilgrastim (Neulasta)... 

Platelets, small cell fragments produced from bone marrow cells, work with the cascade of proteins in the formation of blood clots. If platelet counts are low, leaks in blood vessels that would normally be small can lead to the loss of large amoimts of blood. Certain chemotherapy drugs knock out the production of the cells that produce platelets. Oprelvekin (Neumega ), produced in E. coli, stimulates bone marrow to produce that very important type of cell. 

Recombinant human lL-11 oprelvekin (Neumega) is a bacterially derived, 19,000-dalton polypeptide of 177 amino acids that differs from the native protein only because it lacks the amino terminal proline residue and is not glycosylated. The recombinant protein has a 7-hour half-life after subcutaneous injection. In normal subjects, daily administration of oprelvekin leads to a thrombopoietic response in 5 to 9 days. 

Oprelvekin (Neumega) is the biologic response modifier that stimulates megakary-oq e and thrombocyte production, which stimulates platelet production to prevent thromboq openia in clients receiving chemotherapy. 

Which instructions should the nurse teach the client receiving oprelvekin (Neumega), a hematopoietic growth factor ... 

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