Immunotherapies

Question 1

How can IgG be administered?

Answer 1

IV, IM, SC

Question 2

What are the side effects of IVIG?

Answer 2

fever, chills, HA, malaise, dyspnea, uticaria, thrombosis, hemolysis, kidney injury, anaphylaxis

Question 3

What can you premedicate a patient with before IVIG therapy to help with side effects?

Answer 3

Hydrate, acetaminophen or ibuprofen, histamine blocker (benadryl = diphenhydramine), possibly steroids (prednisone, methylpredinsolone, dexamthasone)

Question 4

What pretests do you want to do before starting treatment with IVIG?

Answer 4

• -blood borne pathogens
• -relevant viral infections
• -renal and liver funtion

Question 5

HBIG
Indications
How is it administered? and w/in what time frame?

Answer 5

indications: post exposure prophylaxis to Hep B
administered: IM (IV available) and w/in 14 days of exposure

Question 6

HBIG
Side effects:
CI:

Answer 6

SE: allergic rxn, back pain, feeling of discomfort, HA, muscle pain, nausea
CI: allergy to human immune globulin

Question 7

Rabies Immune Globulin
Indications
How is it administered?
When do you administer vaccine?

Answer 7

indications: post exposure prophylaxis, pts w/ recent rabies exposure who have never had vaccine
administered: 1x dose, first around wound, rest IM into gluteal region
vaccine: same time

Question 8

Tetanus Immune Globulin
Indications?
How is it administered?
When do you administer vaccine?

Answer 8

Indications: uncertain of pts history of tetanus vaccination or if they have completed their series, and has wound that is unclean or is significant
Administered: IM w/ vaccine

Question 9

Tetanus Immune Globulin
SE
CI

Answer 9

SE: nephritic syndrome, angioedema, anaphylaxis, pain at injection site
CI: allergy to tetanus toxoid, OR if IM injection is CI b/c of bleeding concerns

Question 10

Varicella-Zoster Immune Globulin (VariZIG)
Indications?
Administration?

Answer 10

Indications: post exposure prophylaxis for immunocompromised individuals w/o a history of immunity, newborns of mothers with varicella or zoster w/in 5 days or 48 hours of delivery
Administration: IM

Question 11

Varicella-Zoster Immune Globulin (VariZIG)

SE

Answer 11

SE: chills, fatigue, rash, nausea, thrombosis, anaphylaxis, pain at injection site

Question 12

Rho(D) immune globulin
MOA
Indications?

Answer 12

MO: IgG anti-D antibodies that suppress the mothers immune system from attacking Rh positive blood cells from fetal circulation
Indications: Rh neg mother with Rh positive baby

Question 13

Rho (D) immune globulin

SE:

Answer 13

SE: bp, chills, fever, rash, abd pain, nausea, vommiting, joint pain, back pain, acute renal failure, decreased hemoglobin, increased bilirubin, anaphylaxis, pain at injection site, if given for ITP may also cause hemolysis

Question 14

Rhogam
CI
Administered?

Answer 14

CI: hypersensitivity to immune globulins or prior sensitization to Rho(D)
Administered: 28 wks gestation, after trauma, any procedures during pregnancy, suspicion of hemorrhage, miscariage or abortion
72 hours after delivery if baby is Rh positive

Question 15

Rhogam – what are other uses?

Answer 15

ITP

incompatible blood transfusions

Question 16

Anti-IgE therapy
Xolair-- recombinant monoclonal antibody
What is it used for?
Administration? 
How long until notice effects?

Answer 16

-Used for treatment of moderate to severe persistent asthma after failure of high dose inhaled steroids
-serum IgE = 30-700Iu/mL
Admin: weight based, sub q injections every 2-4 wks
Effects: up to 12 weeks, long term therapy