Immune globulin intramuscular

Hepatitis A Immune globulin (intramuscular [IM]) Preexposure prophylaxis 0.02 mL/ kg IM for anticipated risk of s 3 months, 0.06 mL/kg for anticipated risk of > 3 months, repeated every 4-6 months for continued exposure. Preexposure and postexposure hepatitis A prophylaxis. The availability of hepatitis A vaccine has greatly reduced the need for preexposure prophylaxis. 

Measles Immune globulin (intramuscular) Normal hosts 0.25 mL/kg IM. 1 in in unocom prom ised hosts 0.5 mL/kg IM (maximum 15 mL for all patients). Postexposure prophylaxis (within 6 days after exposure) in nonimmune contacts of acute cases. 

Rubella Immune globulin (intramuscular) 0.55 mL/kg IM. Nonimmune pregnant women exposed to rubella who will not consider therapeutic abortion. Administration does not prevent rubella in the fetus of an exposed mother. 

Varicella-zoster immune globulin, five vials (1.25 mL each) intramuscularly administered ideally within 48 hours of exposure but <96 hours (AIM)... 

Indications and Dosage of Intramuscular Immune Globulin in Infectious Diseases... 

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. 

Three basic approaches are used to control viral diseases vaccination, antiviral chemotherapy, and stimulation of host resistance mechanisms. Vaccination has been used successfully to prevent measles, rubella, mumps, poliomyelitis, yellow fever, smallpox, chickenpox, and hepatitis B. Unfortunately, the usefulness of vaccines appears to be limited when many stereotypes are involved (e.g., rhinoviruses, HIV). Furthermore, vaccines have little or no use once the infection has been established because they cannot prevent the spread of active infections within the host. Passive immunization with human immune globulin, equine antiserum, or antiserum from vaccinated humans can be used to assist the body s own defense mechanisms. Intramuscular preparations of immune globulin may be used to prevent infection following viral exposure and as replacement therapy in individuals with antibody deficiencies. Peak plasma concentrations of intramuscular immune globulins occur in about 2 days. In contrast, intravenously administered immune globulin provides immediate passive immunity. 

Immune globulin, given intramuscularly or intravenously, is recommended in the treatment of primary humoral immunodeficiency, congenital agammaglobulinemias, common variable immunodeficiency, severe combined immunodeficiency, idiopathic thrombocytopenic purpura, and autoimmune hemolytic anemia. There are six licensed preparations of immune globulin. 

The usual dose of Rho(D) immune globulin is 2 mL intramuscularly, containing approximately 300 meg anti-Rh0(D) IgG. Adverse reactions are infrequent and consist of local discomfort at the injection site or, rarely, a slight temperature elevation. Hyperimmune Immunoglobulins... 

A recent presentation by an FDA reviewer noted that for a number of immune globulin products surveyed, no preclinical animal studies were presented in the INDs [14], The immune globulins surveyed included immune globulin (intravenous), as well as hyperimmune globulins both intravenous and intramuscular forms. This situation is likely due to the long history of these products and the similarities in their manufacturing. 

Trimethoprirtr-sulfamethoxazole one doublestrenglh tablet orally once daily (All) Azithromycin 1,200 mg orally once weekly (AQ or darithromydn 500 mg orally twice daily (AO Varicella-zoster immune globulin, five vials (1 25 ml each) intramuscularly administered ideally within 48 hours of etposure but 96 hours (Alll)... 

Respiratory syncytial virus immune globulin (IG) 15 mg/kg intramuscularly (IM) None... 

Varicella zoster virus (VZV) Significant exposure to chickenpox or shingles for patients who have no history of either condition or, if available, negative antibody to VZV Varicella zoster immune globulin (VZIG), 5 vials (1.25 mL each) intramuscularly administered ideally within 48 h of exposure but <96 h... 

Therapeutic Use Rho(D) immune globulin is indicated whenever fetal red blood cells are known or suspected to have entered the circulation of an Rh-negative mother unless the fetus is known also to be Rh-negative. The drug is given intramuscularly. The tj of circulating immunoglobulin is -21-29 days. 

The HBV needlestick situation is best handled by a combination passive-active immunization approach. Immediate and long-term protection is afforded by the administration of hepatitis B vaccine and hepatitis B immune globulin at different intramuscular sites. The answer is (E). 

B. Antitoxin. Human tetanus immune globulin is given at 3000-5000 units intramuscularly, in divided doses, for the treatment of tetanus in children and adults, with part of the dose infiltrated around the wound. Doses of 250-500 units intramuscularly are given for postexposure prophylaxis. 

Two types of products are available for the prevention of hepatitis A immune globulin (IG) and hepatitis A vaccine. IG is a solution of antibodies prepared from human plasma that is made with a serial ethanol precipitation procedure that inactivates HBV and HIV. When administered intramuscularly before exposure to HAV, or within 2 weeks after exposure, IG is >85% effective in preventing hepatitis A. IG administration is recommended for a variety of exposure situations (e.g., for persons who have sexual or household contact with patients who have hepatitis A). The duration of protection is relatively short (i.e., 3-6 months) and dose dependent. 

Alonso, W.R. Trukawinski, S. Savage, M. Tenold, R. Hammond, D. Viral inactivation of intramuscular immune serum globulins. Biologicals 2000, 28, 5-15. 

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