Respiratory Syncytial Virus Immune Globulin Intravenous (Human) (RSV-IGIV)


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Respiratory Syncytial Virus Immune Globulin Intravenous (Human) (RSV-IGIV)
Respiratory Syncytial Virus Immune Globulin Intravenous (Human)
RSV Immune Globulin Intravenous (Human)
Pregnancy Category: C RespiGam (Rx)

Classification: Immunosuppressant

Action/Kinetics: Is an IgG containing neutralizing antibody to RSV. The immunoglobulin is obtained and purified from pooled adult human plasma that has been selected for high titers of neutralizing antibody against RSV. Each milliliter contains 50 mg of immunoglobulin, primarily IgG with trace amounts of IgA and IgM.

Uses: Prevention of serious lower respiratory tract infection caused by RSV in children less than 24 months old with bronchopulmonary dysplasia or a history of premature birth (less than 35 weeks gestation).

Contraindications: History of a severe prior reaction associated with administration of RSV-IGIV or other human immunoglobulin products. Clients with selective IgA deficiency who have the potential for developing antibodies to IgA and which could cause anaphylaxis or allergic reactions to blood products that contain IgA.

Special Concerns: Safety and efficacy have not been determined in children with congenital heart disease. Give close attention to the infusion rate as side effects may be related to the rate of administration. Since RSV-IGIV is made from human plasma, there is the possibility for transmission of blood-borne pathogenic organisms, although the risk is considered to be low due to screening of donors and viral inactivation and removal steps in the manufacturing process.

Side Effects: Infusion of RSV-IGIV may cause fluid overload, especially in children with bronchopulmonary dysplasia. Aseptic meningitis syndrome has been reported within several hours to 2 days following RSV-IGIV treatment. Symptoms include severe headache, drowsiness, fever, photophobia, painful eye movements, muscle rigidity, nausea, and vomiting. The CSF shows pleocytosis, predominately granulocytic, as well as elevated protein levels.
Allergic: Hypotension, anaphylaxis, angioneurotic edema respiratory distress. CNS: Fever, pyrexia, sleepiness. Respiratory: Respiratory distress, wheezing, rales, tachypnea, cough. GI: Vomiting, diarrhea, gagging, gastroenteritis. CV: Tachycardia, increased pulse rate, hypertension, hypotension, heart murmur. Dermatologic: Rash, pallor, cyanosis, eczema, cold and clammy skin. Miscellaneous: Hypoxia, hypoxemia, inflammation at injection site, edema, rhinorrhea, conjunctival hemorrhage.


Reactions similar to other immunoglobulins may occur as follows. Body as a whole: Dizziness, flushing, immediate allergic, anaphylactic, or hypersensitivity reactions. CV: Blood pressure changes, palpitations, chest tightness. Miscellaneous: Anxiety, dyspnea, abdominal cramps, pruritus, myalgia, arthralgia.

Overdose Mangement: Symptoms: Symptoms due to fluid volume overload. Treatment: Administration of diuretics and modification of the infusion rate.

Drug Interactions: Antibodies found in immunoglobulin products may interfere with the immune response to live virus vaccines, including those for mumps, rubella, and measles. Also, the antibody response to diphtheria, tetanus, pertussis, and Haemophilus influenzae b may be lower in RSV-IGIV recipients.

How Supplied: Injection: 2,500 mg RSV Immunoglobulin.

Dosage
?IV Injection Prevention of RSV infections.
1.5 mL/kg/hr for 15 min. If the clinical condition of the client allows, the rate can be increased to 3 mL/kg/hr for the next 15-min period and, finally, increased to a maximum rate of 6 mL/kg/hr from 30 min to the end of the infusion. Do not exceed these rates of infusion.