Unique Plan Description: Elosulfase Alfa (Vimizim) Protocol
Plan Selection Display: Elosulfase Alfa (Vimizim) Protocol
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2019-06-11 15:18:40
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-20 10:30:32
Available at all facilities: No

Elosulfase Alfa (Vimizim) Protocol
Laboratory
	Pregnancy Test Whole Blood - JE
		T;N, Routine, spec type = Blood
IV Solutions
	Sodium Chloride 0.9%
		500 mL, IV, PRN, see comment, T;N, 1 Dose(s)/Time(s), 50 ml/hr
			Comment: nfuse for 5 minutes prior to and 15 minutes after Vimizim infusion and if there is a hypersensitivity reaction
Medications
	Vimizim/NS 250 mL
		250 mL, IV, T;N+30, 12 hr, 6 ml/hr
			Comment: Total volume to infuse over a period > 4.5 hours. Use the rate titration schedule to prevent or ameliorate acute infusion reactions, increasing rate per schedule if tolerated. Stop infusion if patient experiences side effects (facial flushing, prutitis, chest pain, urticarial, rash, headache, change in vital signs or other signs of hypersensitivity) to the previously tolerated rate.  If symptoms subside promptly and the provider has been contacted (Dr Velasco 402-888-1449) and approves, the infusion may be resumed at that lower rate.Rate                         Time6 mL/hour       first 15 minutes12 mL/hour     next 15 minutes24 mL/hour     next 15 minutes36 mL/hour     next 15 minutes48 mL/hour     next 15 minutes60 mL/hour     next 15 minutes72 mL/hour     until infusion completesMaximum infusion rate: 72 mL/hour.Target Dose: elosulfase alfa 2 mg/kg
		2 mg/kg, EVERY BAG
	loratadine
		10 mg, Tab, By Mouth, Once, NOW, T;N
			Comment: 30 minutes prior to Vimizim administration
	diphenhydrAMINE
		25 mg, Tab, By Mouth, Once, NOW, T;N
			Comment: 30 minutes prior to Vimizim administration
	Tylenol
		500 mg, Tab, By Mouth, Once, NOW, T;N
			Comment: 30 minutes prior to Vimizim administration
	hydrocortisone
		50 mg, Tab, By Mouth, Once, NOW, T;N
			Comment: 30 minutes prior to Vimizim administration
	ondansetron
		4 mg, Tablet-Disintegrating, By Mouth, Once, PRN for nausea and/or vomiting, T;N
	Benadryl
		50 mg, Injection, IV Push, Once, PRN for allergic reaction
		25 mg, Injection, IV Push, Once, PRN for allergic reaction
	dexAMETHasone
		10 mg, Injection, IV Push, Once, PRN for allergic reaction
	SOLU-Medrol
		125 mg, Injection, IV Push, Once, PRN for allergic reaction
	Solu-CORTEF
		100 mg, Injection, IV Push, Once, PRN for allergic reaction
	EPINEPHrine
		0.3 mg, Injection, SUBCUTANEOUS, Q5MIN, PRN for anaphylaxis, duration: 3 Dose(s)/Time(s)
		0.3 mg, Injection, IM-Intramuscular, Q5MIN, PRN for anaphylaxis, duration: 3 Dose(s)/Time(s)
	meperidine
		12.5 mg, Syringe, IV Push, Q30MIN, PRN for shivering, duration: 2 Dose(s)/Time(s)
			Comment: May repeat 12.5mg if shivering continues for total of 25mg
Patient Care
	Vital Signs
		With initiation of Vimizim, and every 30 minutes until 15 minutes after infusion ends. If clinically significant changes in vital signs occur, stop the infusion run Sodium Chloride 0.9% at 50ml/hr and contact ordering provider (Dr Velasco 4028881449)
	Notify MD
		Symptoms of moderate to severe reaction or severe hypersensitivity(facial flushing, pruritis, chest pain, urticarial, and rash)
Therapies
	Continuous Pulse Oximetry Monitoring Check
		T;N, BID
			Comment: while receiving Vimizim

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase