Dilution Immune Globulin

Immune Globulin

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Usual Diluents

Dilute with diluent provided

Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]

Dilute with diluent provided

Stability / Miscellaneous

Initial rate: Variable (depends on product)

EXP: Variable. See package insert.
Label: Do not shake/Refrigerate.

Immune globulins with high concentrations of IgA:
(1) Venoglobulin-S (2) Gamimune-N (3) Gammar-P IV (4) Sandoglobulin (5) Panglobulin

Immune globulins with low concentrations of IgA: (1) Polygam S/D (2) Gammagard S/D

Before dispensing, determine if the patient has an IgA deficiency: In patients with IgA deficiency, IgA can be antigenic and anti-IgA antibodies can develop rapidly leading to anaphylaxis when a product containing significant concentrations of IgA is administered. Therefore, use Polygam S/D or Gammagard S/D for IgA deficient patients.

Overview:
IgG is comprised of 4 subclasses with a distribution similar to normal serum (IgG1 thru IgG4). IgG1 is the major component in IGIV preparations. IgG1 is involved in tissue protection, complement activation and virus inactivation. Bacterial cells are opsonized by IgG1, making them more prone to phagocytosis. Treatment of immune deficient states probably depends on straightforward replacement of missing antibodies. Immunomodulatory doses of IVIG for autoimmune conditions are considerably larger & are thought to promote blockade of Fc receptors in macrophages (preventing phagocytosis of circulating opsonized platelets or cells tagged c autoantibodies). IVIG may also neutralize pathogenic auto-antibodies, and possibly down regulate IgG production. According to the National Institutes of Health, the commercially available products are equally effective and they may be used interchangeably. (Exception: IgA deficient patients).

Source: [package insert]