Hepatitis 7-globulins

Infants born to HBsAg-positive mothers should receive hepatitis B vaccine and 0.5 mL hepatitis B immune globulin (HBIG) within 12 hours of birth at separate sites. The second dose is recommended at age 1-2 months and the vaccination series should be completed (third or fourth dose) at age 6 months. 

An example of passive immunity is the administration of immune globulins (see Summary Drug Table Agents for Passive Immunity), such as hepatitis B immune globulin. Administration of this vaccine is an attempt to prevent hepatitis B after the individual has been exposed to the virus. 

Albumin (69 kDa) is the major protein of human plasma (3.4-4.7 g/dL) and makes up approximately 60% of the total plasma protein. About 40% of albumin is present in the plasma, and the other 60% is present in the extracellular space. The liver produces about 12 g of albumin per day, representing about 25% of total hepatic protein synthesis and half its secreted protein. Albumin is initially synthesized as a preproprotein. Its signal peptide is removed as it passes into the cisternae of the rough endoplasmic reticulum, and a hexapeptide at the resulting amino terminal is subsequently cleaved off farther along the secretory pathway. The synthesis of albumin is depressed in a variety of diseases, particularly those of the liver. The plasma of patients with liver disease often shows a decrease in the ratio of albumin to globulins (decreased albumin-globuhn ratio). The synthesis of albumin decreases rela-... 

Managing viral hepatitis involves both prevention and treatment. Prevention of hepatitis A and B (and indirectly for hepatitis D) can be achieved with immune globulin or vaccines. There is no specific pharmacologic treatment for acute viral hepatitis A, B, C, D, or E only supportive care is available. Individuals with mild to moderate symptoms rarely require hospitalization. Occasionally, hospitalization is required in individuals experiencing significant nausea, vomiting, diarrhea, and encephalopathy. Liver transplantation may be required in rare instances if fulminant hepatitis develops. 

Individuals at high risk of acquiring hepatitis A (see Table 21-1) should receive either serum immune globulin or the hepatitis A vaccine, depending on their personal circumstances, as described below.1,5... 

Immune globulin (IG) is a solution containing antibodies from sterilized pooled human plasma that provides passive immunization against various infectious diseases, including hepatitis A.5 Immune globulin is available for either intravenous (IVIG)... 

HB, hepatitis B anti-HBs, hepatitis B surface antibody HBsAg, hepatitis B surface antigen HBIG, hepatitis B immune globulin. 

As noted above, many of the AEDs induce hepatic microsomal enzyme systems and thus reduce the effectiveness of hormonal contraceptives. Women taking AEDs that may reduce the effectiveness of hormonal contraceptives should be encouraged to also use other forms of birth control. Due to induction or inhibition of sex hormone metabolism and changes in binding of hormones to sex hormone binding globulin, some AEDs may reduce fertility. For example, valproate has been associated with a drug-induced polycystic ovarian syndrome. Women who experience difficulties with fertility should seek the advice of health care professionals with expertise in fertility. 

IL-1 (17.5) Monocyte/macrophage, lymphocyte, neutrophil, endothelium, fibroblast keratinocyte Activation of T cells, B cells, natural killer cells, osteoblasts, and endothelium. Induces fever, sleep, anorexia, ACTH release, hepatic acute phase protein synthesis and HSPs. Leads to myocardial depression, hypercoagulability, hypotension/sbock, and death. Simulates production of TNF, IL-6, and IL-8 and stress hormone release. Suppression of cytochrome P-450, thyro-globulin, and lipoprotein synthesis. Procoagulant activity. Antiviral activity. 

Tumor necrosis factor Monoclonal antibody preparations y-Globulin preparations Hepatitis B surface antigen... 

Mild elevations of serum bilirubin, /globulin, and hepatic transaminase (alanine transaminase and aspartate transaminase) values to about twice normal in acute anicteric disease. 

Two products are available for prevention of hepatitis B infection hepatitis B vaccine, which provides active immunity, and hepatitis B immune-globulin (HBIg), which provides temporary passive immunity. 

If mother is hepatitis surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth. 

Estrogen may increase hepatic production of thyroxine-binding globulin (TBG) and decrease TBG clearance, thus increasing serum total thyroxine (tT4) and, to a lesser extent, total triiodothyronine (tT3). As a result, increased tT4 and tT3 are seen in states of excessive estrogen and/or progestin, such as... 

Immune Globulin (IG) IG is a sterile solution containing antibodies from human blood. It is obtained by cold ethanol fractionation of large pools of blood plasma and contains 15-18 percent protein. Intended for intramuscular administration, IG is primarily indicated for routine maintenance of immunity of certain immunodeficient persons and for passive immunity against measles and hepatitis. IG does not transmit hepatitis B virus, human immunodeficiency virus (HIV), or other infectious diseases. 

Hepatitis A vaccine (Havrix) Vaccine Inj 1 mL 1 mL IM folbwed by 1 mL IM 6-12 months later. 96% effective. For immediate protection, give immune globulin (0.02 mL/kg IM) simultaneously. 

In a study which examined the role of the protein 2. -globulin in 1,4-dichlorobenzene-induced nephrotoxicity in male rats, NCI-Black-Reiter (NBR) rats, known not to S5mthesize the hepatic form of the 2. -globulin, were administered 500 mg/kg/day 1,4-dichlorobenzene by gavage in com oil for 4 consecutive days. Positive controls consisted of Fischer 344 male rats treated with lindane the results were also compared with those obtained in a group of female Fischer 344 rats treated with lindane. End points examined consisted of kidney lesions and protein droplet evaluation. 2.-Globulin was detected in kidney sections from male Fischer 344 rats, but not in male NBR or female Fischer 344 rats. No lesions or hyaline droplets were detected in treated or control male NBR and female Fischer 344 rats (Dietrich and Swenberg 1991). 

Studies indicate that renal effects may be specific to certain strains of male rats that synthesize ttzu-globulin. Monkeys, guinea pigs, dogs, mice, female rats, and male NBR rats that do not synthesize the hepatic form of a u-globulin do not develop renal disease in response to isophorone. 

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