Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination(Best Tag) and ask for Clinical Support.
ALWAYS establish IV access prior to mixing any meds
ALWAYS make sure you have everything you need to complete infusion before you begin
ALWAYS confirm your medication dose against the medication label and orders
ALWAYS reach out to us first (not the Pharmacy) with any questions
NEVER tell a Pt you have not given a particular medication before
MIXING
THIS MAY BE A PATIENT TEACH
(Confirm with Care Coordinator if patient teach or RN is to administer)
Obtain a clear/clean space to prepare the NUCALA
Be sure all the necessary supplies are available to complete injection. You will need:
Prefilled autoinjector or prefilled syringe, alcohol, gauze or cotton ball, bandage and sharps container
Remove prefilled autoinjector/prefilled syringe from fridge and remove from tray
Inspect and wait 30 minutes before use (do not use if more than 8 hours)
Look in inspection window and check that the liquid is clear to pale yellow to pale brown in color and without cloudiness or particles
It is normal for there to be 1 or more air bubbles
Choose injection site
It is recommended to use thighs or abdomen or upper arms
Only a caregiver can inject in upper arms
ADMINISTRATION
Take baseline vitals and document basic assessment
Clean injection site with alcohol and allow to air-dry
Start Injection
PREFILLED AUTOINJECTOR
Remove cap from prefilled autoinjector by pulling straight off
It is normal to see a drop of medicine at end of needle
Injection must be given within minutes after removing the clear needle cap
Hold prefilled autoinjector with inspection window visible
Place prefilled autoinjector straight onto injection site with yellow needle guard flat on surface of skin
Push the autoinjector all the way down and keep holding against the skin
There will be a 1st ‘click’ to indicate injection has started
Injection will take up to 15 seconds
After the 2nd ‘click”, continue to hold against the skin and count to 5, before lifting away from the skin
Once injection is completed lift the autoinjector from the skin
PREFILLED SYRINGE
Remove the gray needle cap from prefilled syringe by pulling it straight off, away from needle
It may take some force to remove the gray needle cap.
There may be a drop of medicine at end of needle, and this is normal
Inject within 5 minutes after removing gray needle cap
Use free hand to pinch skin around injection site
Keep pinching skin throughout injection
Insert entire needle into pinched skin at a 45° angle
Move thumb to white plunger and use other fingers to hold onto white grip and slowly push down on white plunger to inject full dose
Make sure white plunger is pushed all the way down until stopper reaches bottom of syringe and all of medicine is injected
Slowly lift thumb up. This allows white plunger to come up and needle to automatically retract into body of syringe
After injection is complete, release pinched skin
Check injection site and gently hold pressure over skin with cotton ball or gauze until bleeding stopped
Do not rub injection site
Cover with bandage if needed
Monitor patient for any adverse reactions
Record vitals 5-10 minutes post infusion
Record lot number and expiration date
Clean and dispose of used supplies
ADDITIONAL INFO
HCP Website: Nucala HCP
Prescribing Info: Nucala PI
Administration Guide: Nucala Admin
Patient Information: Nucala Patient Info