Somatrem

A to Z Drug Facts

 Action Mimics actions of naturally occurring growth hormone to stimulate linear and skeletal growth; increases number and size of muscle cells; increases RBC mass and internal organ size; increases cellular protein synthesis; reduces body fat stores and lipid mobilization; increases plasma fatty acids.

 Indications Long-term treatment of children with growth failure caused by lack of adequate endogenous growth hormone secretion.

 Contraindications Benzyl alcohol sensitivity; closed epiphyses; evidence of tumor activity; intracranial lesions must be inactive and antitumor therapy complete prior to instituting therapy.

 Route/Dosage

CHILDREN: SC/IM Up to 0.1 mg/kg 3 times wkly.

 Interactions

Glucocorticoids: May inhibit growth-promoting effects of somatrem.

 Lab Test Interferences None well documented.

 Adverse Reactions

OTHER: Persistent antibodies to growth hormone.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Hypothyroidism: May develop during therapy. Insulin resistance: May be induced with therapy. Intracranial hypertension: Intracranial hypertension with papilledema, visual changes, headache, nausea or vomiting has been reported in a few patients. Intracranial lesion: Frequently examine patient with history of intracranial lesion for progression or recurrence of lesion. Slipped capital epiphysis: May occur more frequently in patients treated with growth hormone.

 Administration/Storage

• Reconstitute with Bacteriostatic Water for Injection, USP (Benzyl Alcohol Preserved) only. Roll or swirl gently; do not shake.
• Use syringe small enough to permit accurate measurement of drug. Needle should be 1 inch or longer to ensure ability to reach muscle layer.
• Reconstitute with Water for Injection when administering to newborns. Use only one dose per vial. Discard unused portion.
• Rotate injection sites.
• Do not use if solution is cloudy.
• Store before and after reconstitution in the refrigerator. Store reconstituted drug in refrigerator for up to 14 days. Avoid freezing.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Determine if epiphyses are closed and if intracranial lesions and tumor activity are present.
• Examine patients with intracranial lesions frequently to make sure that the lesions are not active.
• Check thyroid function periodically to detect possible hypothyroidism.
• Monitor for signs of acromegaly and report to physician.
• Monitor for glucose intolerance; insulin resistance may develop.
• Monitor patient's growth.
• Observe for common side effects of headache, weakness, localized muscle pain or mild transient edema and report to physician.
• Notify physician of any limp or complaints of hip or knee pain in children; these symptoms indicate slipped capital femoral epiphyses.

 Patient/Family Education

• Instruct diabetic patient to monitor blood sugars closely and to report variations to physician.
• Teach children and parents to report any limp or complaints of hip or knee pain to physician as soon as possible.
• Instruct patient to report these symptoms to physician: headache, weakness, localized muscle pain or mild transient edema.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts