Immune Serum Globulin Human
Indications
Immune Serum Globulin Human is used for:
Chickenpox, Hepatitis A, Measles, Rubella, Immunodeficiency, Wiskott-Aldrich syndrome
Adult Dose
Adult: IV Prevention of infections after bone marrow transplantation 500 mg/kg/wk. Increase platelet count in patients w/ idiopathic thrombocytopenic purpura 400 mg/kg/day for 2-5 consecutive days.
Kawasaki disease 1.6-2 g/kg in divided doses over 2-5 days.
Guillain-Barre syndrome 400 mg/kg/day for 5 consecutive days, repeat 4 wkly if needed.
Allogenic bone marrow transplantation 500 mg/kg/wk, starting 7 days before transplantation and for up to 3 mth after transplantation.
Primary antibodies deficiency Initial: 400-800 mg/kg, then 200 mg/kg 3 wkly. Maintenance: 200-800 mg/kg/mth.
For secondary immunodeficiency syndromes: 200-400 mg/kg 3-4 wkly.
IM Hepatits A 500 mg.
Measles attack in immunocompromised patients Prevention: 750 mg w/in 6 days after exposure. To modify an attack: 250 mg.
Primary rubella in pregnant women 750 mg.
Child Dose
Renal Dose
Administration
Contra Indications
Patients with selective immunoglobulin A deficiency. Prior anaphylactic reactions to immunoglobulin, blood or other blood-derived preparations.
Precautions
Increased risk of acute renal failure in patients with renal impairment, DM, hypovolaemia, overweight, concomitant nephrotoxic medicinal products or >65 yr. High infusion rate may increased risk of adverse reactions. Ensure adequate hydration prior to IV infusion of immunoglobulin. Monitor urine output and serum creatinine levels during treatment. Avoid concurrent use of loop diuretics during IV infusion of immunoglobulin. Live vaccines should generally be given 3 wk before or 3 mth after admin of normal immunoglobulin. Different formulations and brands of human normal immunoglobulins may not be equivalent, thus individual literature should be consulted. Pregnancy and lactation.
Pregnancy-Lactation
Interactions
May interfere with the immune response to live measles vaccine, live mumps vaccine, live rubella vaccine and live varicella vaccine, therefore these vaccines should be given at least 3 wk before or 3 mth after the admin of the immunoglobulins.
Adverse Effects
Side effects of Immune Serum Globulin Human :
Dizziness, light-headedness, nausea, vomiting, allergic and cutaneous reactions. Local pain and tenderness at the site of inj. IV admin may lead to systemic effects such as headache, chills and fever.
Mechanism of Action
Human normal immunoglobulin is derived from donations of pooled human plasma. It contains antibodies, mainly immunoglobulin G (IgG), to various bacteria and viruses present in the general population such as hepatitis A, measles, mumps, rubella and varicella. It has a distribution of IgG subclasses that is very close to that of the normal human plasma. It is therefore, used to provide passive immunisation against such diseases.