Immune Globulin

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Main Medicine Class:: #N/A   Sub Medicine Class ::  #N/A

14B. IMMUNOGLOBULINS in 14. IMMUNOLOGY & ALLERGY
IMMUNE GLOBULIN
BLOOD PRODUCT DERIVATIVE | IMMUNE GLOBULIN

Indications & Dose: GUILLAIN-BARRÉ SYNDROME IV Adult 400mg/kg for 5 consecutive days, repeat q4wks if needed | HEPATITIS A IM Adult 500mg Child >10yr: 250mg, 10-18yr:500mg | IDIOPATHIC THROMBOCYTOPENIC PURPURA IV Adult 400mg/kg/day for 2-5 consecutive days | INFECTION AFTER BONE MARROW TRANSPLANTATION Prophylactic therapy IV Adult 500mg/kg wkly adjust according to response | KAWASAKI DISEASE Combination therapy IV Adult 1.6-2g/kg in divided doses over 2-5 days or 2g/kg as single doseWith aspirin | MEASLES IM Adult 0.5mL/kg, max 15mL immediately following exposure in immunocompromised persons Child Same as adult dose | Prophylactic therapy IM Adult 0.25mL/kg/dose, max 15mL gives within 6days of exposure followed by live vaccine in 5-6months Child 0.25mL/kg/dose, max 15mL gives within 6days of exposure followed by live vaccine in 5-6monthsIn immunocompetent persons | PRIMARY ANTIBODY DEFICIENCIES IV Adult Initially 400-800mg/kg, then 200mg/kg q3wks adjusted according to trough-immunoglobulin concentrations, MD 200-800mg/kg/month | SC Adult Initial loading dose 200-500mg/kg, followed by MD at repeated intervals to achieve a cumulative monthly dose of 400- 800mg/kg | RUBELLA IN PREGNANCY IM Adult 750mgPrevention of clinical attack | SECONDARY IMMUNODEFICIENCY SYNDROMES IV Adult 200-400mg/kg q3-4 wks

Contra: hypersensitivity, severe thrombocytopenia/coagulation disorders, IgA deficiency

Precautions: history of renal diseases, elderly, DM, sepsis, paraproteinemia, volume depletion, history of atherosclerosis, history of thrombotic events, renal impairment

ADR: Serious: angioedema, myalgia, hypersensitivity reactions, anaphylaxis, arthralgia, asthma, increased liver enzymes, conjunctivitis, tachycardia, Others: ear pain, local reactions, pain, systemic reactions, fever, chills, facial flushing, headache, nausea, GI disturbances, injection site reactions like swelling, eczema, cysts, cough

DDI: Serious Vaccines (Live) efficacy is effected, Phenytoin results in hypersensitivity myocarditis

Monitor: Renal function,urine output,anaphylaxis,blood viscosity,infusion related adverse reactions

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