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Pronunciation |
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(i
MYUN GLOB yoo lin, IN tra MUS kyoo
ler) |
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Generic
Available |
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No |
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Synonyms |
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Gamma Globulin; IG; IGIM; Immune Serum Globulin; ISG |
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Pharmacological Index |
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Immune Globulin |
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Use |
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Household and sexual contacts of persons with hepatitis A, measles,
varicella, and possibly rubella; travelers to high-risk areas outside tourist
routes; staff, attendees, and parents of diapered attendees in day-care center
outbreaks |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Thrombocytopenia, hypersensitivity to immune globulin, thimerosal, IgA
deficiency |
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Warnings/Precautions |
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Skin testing should not be performed as local irritation can occur and be
misinterpreted as a positive reaction; do not administer I.V.; IG should
not be used to control outbreaks of measles; epidemiologic and laboratory
data indicate current IMIG products do not have a discernible risk of
transmitting HIV |
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Adverse
Reactions |
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>10%: Local: Pain, tenderness, muscle stiffness at I.M. site
1% to 10%:
Cardiovascular: Flushing
Central nervous system: Chills
Gastrointestinal: Nausea
<1%: Lethargy, fever, urticaria, angioedema, erythema, vomiting, myalgia,
hypersensitivity reactions |
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Drug
Interactions |
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Increased toxicity: Live virus, vaccines (measles, mumps, rubella); do not
administer within 3 months after administration of these
vaccines |
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Stability |
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Keep in refrigerator; do not freeze |
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Mechanism of
Action |
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Provides passive immunity by increasing the antibody titer and
antigen-antibody reaction potential |
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Pharmacodynamics/Kinetics |
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Duration of immune effect: Usually 3-4 weeks
Half-life: 23 days
Time to peak serum concentration: I.M.: Within 24-48 hours
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Usual Dosage |
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I.M.:
Pre-exposure prophylaxis upon travel into endemic areas (hepatitis A vaccine
preferred):
0.02 mL/kg for anticipated risk 1-3 months
0.06 mL/kg for anticipated risk >3 months
Repeat approximate dose every 4-6 months if exposure continues
Postexposure prophylaxis: 0.02 mL/kg given within 2 weeks of exposure
Measles:
Prophylaxis: 0.25 mL/kg/dose (maximum dose: 15 mL) given within 6 days of
exposure followed by live attenuated measles vaccine in 3 months or at 15 months
of age (whichever is later)
For patients with leukemia, lymphoma, immunodeficiency disorders, generalized
malignancy, or receiving immunosuppressive therapy: 0.5 mL/kg (maximum dose: 15
mL)
Poliomyelitis: Prophylaxis: 0.3 mL/kg/dose as a single dose
Rubella: Prophylaxis: 0.55 mL/kg/dose within 72 hours of exposure
Varicella:: Prophylaxis: 0.6-1.2 mL/kg (varicella zoster immune globulin
preferred) within 72 hours of exposure
IgG deficiency: 1.3 mL/kg, then 0.66 mL/kg in 3-4 weeks
Hepatitis B: Prophylaxis: 0.06 mL/kg/dose (HBIG preferred)
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Administration |
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Intramuscular injection only |
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Test
Interactions |
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Skin tests should not be done |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Nursing
Implications |
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Do not mix with other medications; skin testing should not be performed as
local irritation can occur and be misinterpreted as a positive
reaction |
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Dosage Forms |
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Injection: I.M.: 165±15 mg (of protein)/mL (2 mL, 10
mL) |
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References |
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ASHP Commission on Therapeutics,
"ASHP Therapeutic Guidelines for Intravenous Immune Globulin," Clin
Pharm, 1992, 11(2):117-36.
Berkman SA, Lee ML, and Gale RP,
"Clinical Uses of Intravenous Immunoglobulins," Ann Intern Med, 1990,
112(4):278-92. |
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