Intravenous infusion therapy

Infliximab 5 mg/kg is also an option for severe UC. Cyclosporine 2 to 4 mg/kg per day given as a continuous intravenous infusion should be reserved for patients unresponsive to 7 to 10 days of intravenous corticosteroid therapy. 

Thompson, J.A. et al., Prolonged continuous intravenous infusion interleukin-2 and lym-phokine-activated killer-cell therapy for metastatic renal cell carcinoma., J. Clin. Oncol., 10, 960, 1992. 

Infliximab is licensed for the management of severe active Crohn s disease and in rheumatoid arthritis. Maintenance therapy with infliximab should be considered for patients who respond to the initial induction course. Infliximab is administered by intravenous infusion and, for severe active Crohn s disease, it is started initially with 5 mg/kg and then 5 mg/kg 2 weeks after the initial dose. 

Therapy, when replacement of the marrow by allogeneic haematopoietic stem cell transplantation is not possible, comprises 500 mg of methylpred-nisolone by 8 hour intravenous infusion repeated for five consecutive days. Concurrently 15 mg/kg of antilymphocyte or antithymocyte globulin is given... 

Therapy is relatively simple and requires only intravenous infusion of gammaglobulin. Unfortunately, the cost is high although it is essential to appreciate that such replacement therapy does not necessarily need to raise the amounts of protein in the plasma to be life-saving. The important clinical requirement is the decrease and preferable abolition of acute bacterial infections. 

The limiting side effect associated with orally administered Pz-adrenoceptor agonists is muscle tremor, which results from a direct stimulation of Pz-adreno-ceptors in skeletal muscle. This effect is most notable on the initiation of therapy and gradually improves on continued use. 2-Agonists also cause tachycardia and palpitations in some patients. When used by intravenous infusion for premature labor, P2-agonists have been re-... 

The most common side effects, which are related to the intravenous infusion itself, include rash, low blood pressure, chills, and chest pain. These symptoms are generally temporary and often respond to a decrease in infusion rate. In addition, some patients develop antibodies, which have been associated in rare cases with symptoms similar to those of patients with systemic lupus erythematosus. These symptoms were also temporary. Another side effect is increased risk of infections. Fatal cases of tuberculosis have been reported following infliximab therapy. Another potential side effect is an increased risk of lymphoma. Its occurrence remains controversial. 

The major adverse effect associated with vancomycin therapy is ototoxicity, which may result in tinnitus, high-tone hearing loss, and deafness in extreme instances. More commonly, the intravenous infusion of vancomycin can result in chills, fever, and a maculopapular skin rash often involving the head and upper thorax (red man syndrome). Red man syndrome is associated with increased levels of serum histamine. Vancomycin is rarely nephrotoxic when used alone. Teicoplanin rarely causes red man syndrome or nephrotoxicity. 

Oral capsules of ganciclovir have been associated with the risk of rapid-rate CMV retinitis progression and should be used as a maintenance therapy only in patients who benefit from avoiding daily intravenous infusions. 

Recommended dosage and monitoring requirements Campath therapy should be initiated at a dose of 3 mg administered as a 2-hour intravenous infusion daily. When the Campath 3 mg daily dose is tolerated, the daily dose should be escalated to lOmg and continued. When the lOmg dose is tolerated, the maintenance dose of Campath 30mg may be initiated.The maintenance dose of Campath is 30mg/day administered three times per week on alternate days (i.e., Monday, Wednesday, and Friday) for up to 12 weeks. In most patients, escalation to 30 mg can be accomplished in 3 to 7 days. Premedication should be given prior to the hrst dose, at dose escalations, and as clinically indicated. The premedication used in clinical studies was diphenhydramine 50 mg and acetaminophen 650 mg administered 30 minutes prior to Campath infusion. Patients should receive anti-infective prophylaxis to minimize the risks of serious opportunistic infections. 

Infliximab is given as an intravenous infusion at doses of 3-10 mg/kg, although the usual dose is 3-5 mg/kg every 8 weeks. There is a relationship between serum concentration and effect, although individual clearances vary markedly. The terminal half-life is 9-12 days without accumulation after repeated dosing at the recommended interval of 8 weeks. After intermittent therapy, infliximab elicits human antichimeric antibodies in up to 62% of patients. Concurrent therapy with methotrexate markedly decreases the prevalence of human antichimeric antibodies. 

EDTA has been shown to be of value in the therapy of lead intoxication. It can be administered either deep intramuscularly or by slow intravenous infusion. The dose of 75 mg/kg/day should be administered in 3-6 divided doses for up to 5 days this dosage... 

Warning Acyclovir sodium is intended only for intravenous infusion, which should be given over a period of 1 hour to reduce the risk of renal tubular damage Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), which has resulted in death, has occurred in immunocompromised patients receiving acyclovir therapy. 

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