Article Contents ::
- 1 Details About Generic Salt :: Rho
- 2 Main Medicine Class::
- 3 administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container. Antepartum Prophylaxis 1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy. Threatened Abortion Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed. Amniocentesis or Abdominal Trauma Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed. Transfusion Accidents Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs. Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion. Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases. Adverse Reactions OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely. Precautions Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy. PATIENT CARE CONSIDERATIONS Administration/Storage Administer IM only. If desirable, divide total dose and give at different injection sites or inject at intervals. Give total dosage within 72 hr. Store in refrigerator. Confirm mother is Rho(D) negative prior to administration. Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration. Assessment/Interventions Obtain patient history, including drug history and any known allergies. Observe injection site for tenderness or erythema. Administer with caution if patient is receiving anticoagulants. Notify physician if fever, splenomegaly, myalgia, or lethargy develop. Assess bilirubin levels prior to and following treatment. Patient/Family Education Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician. Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug. Explain how future Rho-positive infants will be protected.
- 4 Drugs Class ::
- 5 Disclaimer ::
- 6 The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.
Details About Generic Salt :: Rho
Main Medicine Class::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases.
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.
Drugs Class ::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases.
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS |
|
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.
Indications for Drugs ::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases.
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS |
|
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.
Drug Dose ::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Contraindication ::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases.
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS |
|
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.
Drug Precautions ::
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS |
|
Drug Side Effects ::
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Drug Mode of Action ::
administer ³ 1 container of RhIG. One minidose container of RhIG will prevent formation of anti-Rh antibodies resulting from spontaneous or induced abortion up to 12 wk gestation. After 12 wk gestation, give full-dose container.
Antepartum Prophylaxis
1 full-dose container of RhIG at 28 wk gestation and again within 72 hr after Rh-incompatible delivery is highly effective in preventing Rh isoimmunization during pregnancy.
Threatened Abortion
Following threatened abortion at any stage of gestation with continuation of pregnancy, give 1 full-dose container of RhIG, unless larger dose is needed.
Amniocentesis or Abdominal Trauma
Following amniocentesis at either 15 to 18 wk gestation or during third trimester, or following abdominal trauma in second or third trimester, give 1 full-dose container of RhIG, unless larger dose is needed.
Transfusion Accidents
Dose of RhIG is dependent on volume of red cells or whole blood transfused. To determine amount of RhIG needed, multiply volume (measured in mL) of Rh antigen-positive whole blood administered by Hct of donor unit. This value equals volume of RBCs transfused. Divide volume of RBCs by 15 to obtain dose of RhIG needed. If dose calculation results in fraction, administer next higher whole number of full-dose vials or syringes of RhIG. Rh antigen-negative patients who receive Rh antigen-positive blood have received as many as 15 to 33 vials of RhIG without adverse reaction. If any event requires administration of RhIG at 13 to 18 wk gestation, give another full dose at 26 to 28 wk gestation. Give additional full dose of RhIG within 72 hr after delivery if infant is Rh antigen-positive. If delivery occurs within 3 wk after last dose, postpartum dose may be withheld, unless there is fetomaternal hemorrhage of > 15 mL RBCs.
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Lab Test Interferences Infants born of women given RhIG antepartum may have weakly positive antiglobulin (Coombs’) test result at birth. Anti-Rh antibodies may be detected in maternal serum within several wk of administration of RhIG. Such finding does not preclude further RhIG doses. Presence of RhIG antibodies in maternal blood sample can affect interpretation of tests to identify patient as candidate for RhIG. In case of doubt as to patient’s Rh group or immune status, give RhIG. Significant fetomaternal hemorrhage late in pregnancy or following delivery may cause weak, mixed-field positive Du test result. If there is any doubt about mother’s Rh type, give RhIG. Screening test for fetal RBCs may help in such cases.
Adverse Reactions
OTHER: As with most IgG products, adverse reactions are infrequent, usually mild in nature and generally confined to site of injection. Occasional patient may react more strongly with localized tenderness, erythema, or low-grade fever. Fever, splenomegaly, myalgia, lethargy, and elevated bilirubin levels occur in some individuals receiving multiple doses of RhIG following mismatched transfusions. This latter reaction may be due to relatively rapid rate of foreign red cell destruction, not to RhIG. Hypersensitivity and systemic reactions and induced sensitization with repeated injections occur rarely.
Precautions
Pregnancy: Category C. Lactation: Undetermined. Children: For suppression of Rh isoimmunization in the mother. Do not administer to infants. IM administration: As with other drugs administered by IM injection, give RhIG with caution to patients on anticoagulant therapy.
PATIENT CARE CONSIDERATIONS |
|
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.
Drug Interactions ::
Interactions Antibodies in RhIG may interfere with response to live vaccines. Do not give live vaccines within 14 to 30 days before or 3 mo after RhIG administration. Nonetheless, RhIG does not usually impair response to rubella vaccine. Rubella-susceptible postpartum women who received blood products or RhIG may receive rubella vaccine prior to discharge, provided that rubella antibody titer is drawn 6 to 8 wk after vaccination to ensure seroconversion.
Drug Assesment ::
Assessment/Interventions
- Obtain patient history, including drug history and any known allergies.
- Observe injection site for tenderness or erythema.
- Administer with caution if patient is receiving anticoagulants.
- Notify physician if fever, splenomegaly, myalgia, or lethargy develop.
- Assess bilirubin levels prior to and following treatment.
Drug Storage/Management ::
Administration/Storage
- Administer IM only.
- If desirable, divide total dose and give at different injection sites or inject at intervals.
- Give total dosage within 72 hr.
- Store in refrigerator.
- Confirm mother is Rho(D) negative prior to administration.
- Obtain blood type and direct antiglobulin test on infant immediately postpartum, prior to administration.
Drug Notes ::
Patient/Family Education
- Tell patient to report fever, myalgia, lethargy, abdominal pain, or jaundice to physician.
- Instruct patient not to receive any live vaccines within 30 days before or 3 mo after administration of drug.
- Explain how future Rho-positive infants will be protected.