Intravenous immunoglobulin: Difference between revisions
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*Hepatic dosing: no adjustment | *Hepatic dosing: no adjustment | ||
==Indications== | |||
*FDA-approved indications: | |||
**[[Immune thrombocytopenic purpura]] | |||
**[[Kawasaki]] | |||
**Common variable immunodeficiency, primary immunodeficiency associated with humoral imunodeficiency | |||
**Kidney transplant with high antibody recipient or ABO incompatible donor | |||
*Chronic B-cell leukemia, [[stem cell transplantation]] | |||
*Off-label indications | |||
**[[TTP]], [[HUS]] | |||
**[[Aplastic anemia]], autoimmune [[hemolytic anemia]] | |||
**[[Myasthenia gravis]], [[Lambert-Eaton myasthenic syndrome]] | |||
**[[Guillain-Barre syndrome]] | |||
**[[Anti-NMDA receptor encephalitis]] | |||
**Severe [[Pyoderma]], severe [[Pemphigus vulgaris]] | |||
**Acute [[GVHD]] | |||
**Immune-mediated [[neutropenia]] | |||
**Recurrent [[C. diff]] | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
| Line 42: | Line 59: | ||
*Hyperthermia | *Hyperthermia | ||
*Nausea, vomiting, diarrhea, abdominal pain | *Nausea, vomiting, diarrhea, abdominal pain | ||
*Aphthous ulcer | *[[Aphthous ulcer]] | ||
*Arthralgia, myalgia, backache, headache | *Arthralgia, myalgia, backache, headache | ||
*Dizziness, fatigue | *Dizziness, fatigue | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Interference with Fc receptors on the cells of the reticuloendothelial system for autoimmune cytopenias and ITP | |||
==See Also== | ==See Also== | ||
Latest revision as of 23:16, 7 March 2021
Administration
- Type: Immunologic agent
- Dosage Forms:
- Routes of Administration: IV
- Common Trade Names: Gammagard, Gammar-IV, Gamimune-N, Camunex, Carimune/Panglobulin, Iveegam, Polygam S/D, Sandoglobulin, Venoglobulin, KIOVIG
Note: components of each brand vary
Adult Dosing
Varies depending on formulation
Pediatric Dosing
Varies depending on formulation
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk minimal
- Renal dosing: administer at minimum infusion rate possible
- Hepatic dosing: no adjustment
Indications
- FDA-approved indications:
- Immune thrombocytopenic purpura
- Kawasaki
- Common variable immunodeficiency, primary immunodeficiency associated with humoral imunodeficiency
- Kidney transplant with high antibody recipient or ABO incompatible donor
- Chronic B-cell leukemia, stem cell transplantation
- Off-label indications
- TTP, HUS
- Aplastic anemia, autoimmune hemolytic anemia
- Myasthenia gravis, Lambert-Eaton myasthenic syndrome
- Guillain-Barre syndrome
- Anti-NMDA receptor encephalitis
- Severe Pyoderma, severe Pemphigus vulgaris
- Acute GVHD
- Immune-mediated neutropenia
- Recurrent C. diff
Contraindications
- Allergy to class/drug
- Hereditary intolerance to sucrose or fructose
- Hyperprolinemia
- IgA deficiency with antibodies
- all IVIG contain trace IgA
- Gammagard and Polygram have the least
Adverse Reactions
Serious
- MI, chest pain
- Tachycardia
- Hemolytic anemia
- Thrombosis, PE
- Acute renal failure
- Hyponatremia
- Aseptic meningitis
- Transfusion related acute lung injury
Common
- Hypertension, hypotension
- Peripheral edema
- Pruritus, rash, injection site reaction
- Hyperthermia
- Nausea, vomiting, diarrhea, abdominal pain
- Aphthous ulcer
- Arthralgia, myalgia, backache, headache
- Dizziness, fatigue
- Otalgia
- Asthma, nasal congestion, wheezing, pharyngitis
- Fever, rigors, shivering
- Infusion reaction
Pharmacology
- Half-life: 5-37 days
- Metabolism:
- Excretion:
Mechanism of Action
- Interference with Fc receptors on the cells of the reticuloendothelial system for autoimmune cytopenias and ITP