Alberta Rheumatology



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|Please write firmly with a black ballpoint pen. |Do not change or add orders in any section where orders have previously |

|All orders must be signed by the physician. All co-signatures must be timed |been written. |

|and dated within 24 hours. | |

|Policies and procedures regarding patient care orders are contained in the UAH|Allergies _______________________ ( Diabetic Record |

|Policy and Procedures Manual. | |

|Date/Time |Standing orders for the administering Benlysta (belimumab) |

|- -2011 |Preinfusion: |

| |Temperature, Pulse and blood pressure sitting |

| |Pre-medication (5-10 minutes prior to infusion) |

| | ( benadryl _____mg IV OR No Pre-medication ( |

| | ( solucortef _____mg IV |

| | ( acetaminophen 650 mg PO |

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| |Infusion: (dose 10 mg/kg) |

| |Belimumab _____mg IV in 0.9% Sodium Chloride only to a total volume of 250 ml |

| |to be infused over 1 hours |

| |Repeat infusion at week 2 and week 4, then q4w thereafter. |

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| |If adverse reaction to belimumab: |

| |Stop infusion, maintain normal saline IV at 150 ml/hour |

| |Page Rheumatologist |

| |If mild to moderate itching and/or rash without respiratory difficulty |

| | administer benadryl 50 mg IV stat |

| |If itching or hives with respiratory difficulty or wheezing administer |

| | benadryl 50 mg IV stat and start oxygen 5 litres/ min NP |

| |If reaction worsens or persists more than 30 minutes, administer |

| | solucortef 100 mg IV stat |

| |Once infusion reaction has resolved, resume infusion at slower rate if tolerted |

| |If anaphylactic reaction administer epinephrine (1:1000 ) 0.1- 0.5 ml sc (may repeat |

| | q5min x 3) start oxygen 5 litres/ min NP, solucortef 100 mg IV stat and page |

| | physician stat |

| |Do not restart belimumab. |

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| |Post infusion: |

| |Temperature, Pulse and blood pressure sitting. |

| |Patient to remain on nursing unit x 1 hour after initial infusion, then d/c if feeling well |

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University

of Alberta

Hospitals

Patient Care Orders

3830-02086-APR 94 – 150M

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