Details About Generic Salt ::  Immune1

Main Medicine Class:: Immune serum   

(ih-MYOON GLAH-byoo-lin intravenous)
Gamimune N, Gammagard S/D, Gammar-P I.V., Iveegam, Polygam, Polygam S/D, Sandoglobulin, Venoglobulin-I, Venoglobulin-S,  Iveegam Immuno
Class: Immune serum

 

Drugs Class ::

 Action Replaces normal human IgG antibodies. Promotes opsonization, fixes complement, and neutralizes bacteria, viruses, fungi, and parasites, and their toxins.

Indications for Drugs ::

 Indications Treatment of primary immunodeficiency states in patients unable to produce sufficient amounts of IgG antibodies; prevention of bacterial infections in patients with hypogamma globulinemia, recurrent bacterial infections associated with B-cell chronic lymphocytic leukemia or Kawasaki disease, children with AIDS, and bone-marrow transplant patients; treatment of immune thrombocytopenia purpura. Unlabeled use(s): Chronic fatigue syndrome; quinidine-induced thrombocytopenia.

Drug Dose ::

 Route/Dosage

Immunodeficiency Syndrome

ADULTS AND CHILDREN: Gammagard: IV 200 to 400 mg/kg initially; then monthly doses of ³ 100 mg/kg are recommended.

Gammar S/D: IV Initial dose of 0.5 mL/kg/hr. Eventual: 5%: 4 mL/kg/hr; 10%: 8 mL/kg/hr.

Gammar-P: IV Initial dose: 0.6 mL/kg/hr × 15 to 30 min. Eventual: 1.2 to 3.6 mL/kg/hr.

Gammar-IV: IV Initial loading dose of ³ 200 mg/kg; then 100 to 200 mg/kg q 3 to 4 wk.

Gamimune N: IV 100 to 200 mg/kg monthly. If clinical response or level of IgG is insufficient, increase dose to 400 mg/kg or repeat infusion more frequently. Pediatric HIV infection: 400 mg (8 mL/kg) q 28 days.

Iveegam: IV 200 mg/kg monthly. If clinical response or level of IgG is insufficient, increase dose 4-fold or repeat infusion more frequently. Doses up to 800 mg/kg monthly have been tolerated.

Polygam: IV 200 to 400 mg/kg recommended initially; then 100 mg/kg monthly. Doses based on monitoring clinical response.

Polygam S/D: IV Initial: 0.5 mL/kg/hr. Eventual: 5%: 4 mL/kg/hr; 10%: 8 mL/kg/hr.

Sandoglobulin: IV 200 mg/kg monthly. If clinical response or level of IgG is insufficient, increase dose to 300 mg/kg or repeat infusion more frequently.

Venoglobulin-I: IV 200 mg/kg monthly. If clinical response or level of IgG is insufficient, increase dose to 300 to 400 mg/kg or repeat infusion more frequently.

Immune Thrombocytopenic Purpura

ADULTS AND CHILDREN: Gammagard: IV 1000 mg/kg. Give up to 3 doses on alternate days if required, based on clinical response and platelet count.

Gammagard S/D: IV Initial dose of 0.5 ml/kg/hr. Eventual: 5%: 4 mL/kg/hr; 10%: 8 mL/kg/hr.

Gamimune N: IV 400 mg/kg for 5 consecutive days.

Polygam: IV 1000 mg/kg recommended initially; then additional doses determined by clinical response and platelet count. Up to 3 doses may be given on alternate days if needed.

Polygam S/D: IV Initial: 0.5 mL/kg/hr. Eventual: 5%: 4 mL/kg/hr; 10%: 8 mL/kg/hr.

Sandoglobulin: IV 400 mg/kg for 2 to 5 consecutive days.

Venoglobulin-I: IV Induction: 500 mg/kg/day for 2 to 7 consecutive days. Patients responding to induction therapy by manifesting platelet count of 30,000 to 50,000/mm3 may be discontinued after 2 to 7 daily doses. Maintenance: If platelet count falls below 30,000/mm3 or patient manifests significant bleeding, infuse 500 to 2000 mg/kg as single dose q 2 wk or less as needed to maintain platelet count above 30,000/mm3 in children and 20,000/mm3 in adults.

B-Cell Chronic Lymphocytic Leukemia

ADULTS AND CHILDREN: Gammagard: IV 400 mg/kg q 3 to 4 wk.

Polygam: IV 400 mg/kg q 3 to 4 wk.

Contraindication ::

 Contraindications Immediate hypersensitivity to human antibody product; circulating anti-IgA antibodies; possible aseptic meningitis syndrome.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Renal: Has been associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death. Hypersensitivity: Hypersensitivity, including anaphylaxis, may occur.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Palpitations; hypotension; hypertension. CNS: Anxiety; dizziness; headache. GI: Nausea; vomiting; abdominal cramps. RESP: Shortness of breath; wheezing. OTHER: Pallor; cyanosis; immediate anaphylactic and hypersensitivity reactions; back pain; chills; muscle or joint pain; arthralgia; malaise; flushing; chest tightness.

Drug Mode of Action ::  

 Action Replaces normal human IgG antibodies. Promotes opsonization, fixes complement, and neutralizes bacteria, viruses, fungi, and parasites, and their toxins.

Drug Interactions ::

 Interactions

Live vaccines: To avoid inactivating vaccines containing live viruses or bacteria, give live vaccines 2 to 4 wk before or 3 to 11 mo after IGIV depending on dose. INCOMPATIBILITIES: Admixture: Do not mix IGIV with other medications.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Keep epinephrine (1:1000) and resuscitation equipment readily available.
  • Monitor vital signs continuously and observe for adverse symptoms (eg, anaphylaxis, fever, chills, nausea, vomiting) throughout infusion.
  • If adverse reactions such as fever, chills, nausea, or vomiting develop, slowing infusion rate will usually eliminate reaction.

Drug Storage/Management ::

 Administration/Storage

  • Administer via IV infusion only. Use separate IV line and electronic infusion device.
  • Proceed with infusion only if reconstituted solution is clear and is at approximate body temperature.
  • Store Gamimune N and Iveegam in refrigerator.
  • Store Sandoglobulin, Gammagard S/D, Gammar-P, Polygam S/D, and Venoglobulin-I at room temperature.
  • Discard any unused solution.
  • Avoid freezing. Do not use solution that has been frozen.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to notify physician immediately of nausea, chills, shortness of breath, headache, and chest tightness during infusion.

Disclaimer ::

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