Muromonab efficacy

Lactation It is not known whether muromonab-CD3 is excreted in breast milk. Children Safety and efficacy in children have not been established. Muromonab-CD3 has been used in infants/children, beginning with a dose of 5 mg or less. 

Echinacea (Echinacea purpurea) Uses immune system stimulant prevention/Rx of colds, flu as supportive th apy for colds chronic infxns of the resp tract lower urinary tract Action Stimulates phagocytosis cytokine production T resp cellular activity topically exerts anesthetic, antimicrobial, anti-inflammatory effects Efficacy Not established may X severity duration of URI Available forms Caps w/ powdered herb equivalent to 300-500 mg, PO, tid pressed juice 6-9 mL, PO, once/d tine 2-4 mL, PO, tid (1 5 dilution) tea 2 tsp (4 g) of powdered herb in 1 cup of boiling water Noles/SE Fever, taste p -version, urticaria, angioedema Contra w/ autoimmune Dz, collagen Dz, progressive systemic Dz (TB, MS, collagen-vascular disorders), HIV, leukemia, may interfere w/ immunosuppressive therapy Interactions t Risk of disulfiram-like reaction W/ disulfiram, metronidazole T risk of exacerbation of HIV or AIDS W/ chinacea amprenavir, other protease inhibitors X effects OF azathioprine, basiliximab, corticosteroids, cyclosporine, daclizumab, econazole vag cream, muromonab-CD3, mycophenolate, prednisone, tacrolimus EMS Possible immunosuppression... 

Several anti-human T cell monoclonal antibodies have undergone preliminary trials in the treatment of renal allograft rejection. Most of these monoclonal antibodies were not effective than muromonab (1). T10B9, an antihuman pan-T lymphocyte monoclonal antibody, had similar efficacy but caused less fever, severe infection, respiratory, gastrointestinal, or neurological sjmptoms than muromonab (SEDA-22, 409). Other monoclonal antibodies, such as chimeric anti-CD7 and murine anti-ICAM-1 (CD54 enhmomab), were devoid of adverse effects or produced only minimal and transient adverse effects (SED-13,1134). 

Anti-CD3 Monoclonal Antibodies Antibodies directed at the e chain of CD3, a trimeric molecule adjacent to the T-ceU receptor on the surface of human T lymphocytes, have been used with considerable efficacy in human transplantation. The original mouse IgG, antihuman CDS monoclonal antibody, muromonab-CD3 (OKT3, ORTHOCLONE okt3), stiU is used to reverse glucocorticoid-resistant rejection episodes. 

Therapeutic Uses Muromonab-CD3 is indicated for treatment of acute organ transplant rejection. The recommended dose is 5 mg/day (in adults less for children) in a single intravenous bolus (<1 minute) for 10-14 days. Antibody levels increase over the first 3 days and then plateau. Circulating T cells disappear from the blood within minutes of administration and return within 1 week after cessation of therapy. Repeated use of muromonab-CD3 results in the immunization of the patient against the mouse determinants of the antibody, which can neutralize and prevent its immunosuppressive efficacy. Thus, repeated treatment with the muromonab-CD3 or other mouse monoclonal antibodies generally is contraindicated. 

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