The frequency of infusions depends upon many factors and will need to be determined by your doctor. Please discuss your anticipated therapy plan with him or her.
Are infusions painful? Most infusion medications are not painful to receive. The placement of the IV catheter may feel painful to some people. Providers often have many ways to decrease the pain of inserting an IV catheter, including using numbing creams and sprays, distraction techniques and devices which provide physical pain blocking using cold and vibration. Check with your doctor to see which pain control plan might work best for you.
Are there any side effects to infusions? Side effects can develop with any intravenous infusion. Severe adverse events can occur but are rare. Some side effects can be reduced by premedication with certain medicines. Please check with your doctor to receive a complete list of the side effects of the medications that have been prescribed for you.
He or she will choose treatments to minimize your risk. With IVIG, you may develop a headache during or after your infusion. Intravenous immunoglobulin IVIg infusion Intravenous immunoglobulin commonly referred to as IVIg is used to treat many immune deficiency disorders and inflammatory conditions.
Why does my child need IVIg? There are two main reasons children are prescribed IVIg treatment: Immune replacement therapy: IVIg given to babies or children who do not make enough of their own antibodies to fight infections.
These infections may be present from birth or develop as a result of other diseases or treatments, e. IVIg may help reduce the chance of developing an infection and will likely need to be given repeatedly Immunomodulation therapy: Prescribed when the immune system attacks the body's normal cells. IVIg may help to regulate the immune system to improve symptoms.
If your child needs IVIg, your doctor will discuss with you: why they think your child needs an IVIg infusion the likely benefits any risks if there are any alternatives. Giving consent You will be asked to sign a consent form to allow your child to have an IVIg infusion.
The clinical staff at the Australian Red Cross Blood Service who authorise IVIg require this information to ensure: the correct type of IVIg product is authorised for the correct medical condition the correct dose is given to your child that the IVIg is shipped to the correct hospital. What to expect with an IVIg infusion Unless your child already has one, an IV will be inserted into a vein, which may cause some brief pain and discomfort.
What are the risks? Key points to remember Your doctor will speak with you about why your child needs an IVIg infusion and ask for your consent before the procedure.
IVIg is carefully tested so that the risk of getting an infection or virus is very small. Nursing staff will monitor your child carefully during the IVIg infusion. The use of medications like steroids, non-steroidal anti-inflammatories NSAIDs , acetaminophen, and diphenhydramine and staying well hydrated can help to prevent these complications.
In formulations of IVIG with a high sugar content, the sugar level in the blood may be affected transiently following an infusion. This can often be avoided by slowing down the infusions and hydrating the body well.
Additionally, because the medication has a large volume, it may worsen heart failure and may cause the blood pressure to be elevated temporarily. IVIG also increases the risk for blood clots slightly when given in high doses. If you develop a severe reaction difficulty breathing, chest tightness, wheezing, rash, fevers or if have severe and persistent headaches with neck stiffness, nausea and vomiting, tell your rheumatology provider. While some reactions may occur while IVIG is being administered, others occur within a few hours to days after the infusion.
While vaccines are not contraindicated while on therapy with IVIG, your body may not be able to fully respond to the vaccines. IgG levels are monitored over time, correlated with clinical outcomes, and the dose is adjusted as necessary.
The number of needle-sticks may be reduced by increasing the volume infused per site. Conversely, more sites may be needed if the less concentrated solutions are used.
If the individual is experiencing discomfort using the abdomen, other sites such as the thighs can be used. If the individual prefers to dose every month rather than weekly or every two weeks, then facilitated SCIG using one to two sites may be the best choice.
For those who have issues with tolerating infusions, smaller volumes of SCIG daily may be needed. Several needle lengths are also available that can be tried; the important thing is to use a needle long enough to ensure that the Ig is being administered into the subcutaneous tissues rather than the skin. A variety of infusion pumps are available ranging from a simple and portable mechanical pump to more complicated programmable pumps. Most importantly, SCIG can provide freedom of scheduling for those who self-infuse, resulting in fewer school and workday losses.
SCIG can be considered for children, adults, pregnant women, the elderly, and for individuals with IgA deficiency secondary to having antibodies against IgA very rare. Systemic side effects are usually mild. Severe reactions rarely occur, but individuals who have had severe reactions to IVIG might be at a higher risk. Pre-medication is usually not required for SCIG. The most common adverse reaction reported is local redness, swelling, and irritation at the injection site.
Usually these mild localized reactions improve with repeated infusions. In rare cases, the injection site reactions can be severe. To improve or avoid the infusion site reactions, and decrease the chance of other problems, individuals need thorough training to ensure that proper technique is used to access the subcutaneous tissue. Local skin reactions may be due to inadequate needle length preventing the Ig from being infused into the subcutaneous tissue.
For those with fear of needles, a topical numbing medicine or ice can be applied to the skin prior to the subcutaneous infusion. Monitoring: With SCIG, there is a steady state level of IgG in the circulation due to more frequent infusions of smaller doses and the fact that the Ig is more slowly absorbed. Peak and trough levels are not as extreme, and the level is more consistent on a daily basis.
Routine lab work including blood counts and markers of liver and kidney functions should be monitored. None of the currently available products for SCIG, are stabilized with sucrose, making renal complications less likely. Smaller doses given subcutaneously also minimize risks due to fluid overload. Practical Considerations: Many practical considerations should be taken into account when deciding if SCIG is the right choice.
SCIG requires more frequent administrations daily, weekly, every two weeks , unless the facilitated SCIG route is chosen every three to four weeks. Medical supervision is not required for home infusion, so the ability of the individual to adhere to the treatment regimen is an important consideration.
If there is a fear of needle-sticks, training strategies for self-infusion including numbing creams should be considered. Manual dexterity, or the ability to make coordinated hand and finger movements to manipulate objects, is also required to draw up SCIG and manage the pump.
SCIG provides the freedom to administer Ig at home or anywhere else at any time of day. This flexibility and control have been shown to enhance the quality of life for many individuals 9.
SCIG is associated with a lower rate of systemic side effects, making this route of administration a good option for those experiencing unwanted adverse effects from IVIG. Administration of more frequent, smaller volumes provides a steady level of Ig, avoiding high peak levels that may be associated with side effects of IVIG, such as headaches and symptoms of wear-off.
SCIG should be given serious consideration for college students and those individuals whose jobs require frequent travel. Individuals should remember that there are many options available for therapy and that they should thoroughly discuss these options with their prescribers. The goal of Ig replacement therapy for antibody disorders—no matter the route of administration—is to provide protection from infection.
Any barriers to therapy, real or potential, need to be addressed appropriately. It is also important to remember several things when considering Ig replacement therapy:. Table is designed to facilitate a discussion between individuals and caregivers living with PI and their healthcare providers when immunoglobulin Ig replacement therapy is determined to be the treatment of choice and is deemed medically necessary.
Decisions on which therapy is best should be made with some of these factors in mind. Information regarding the Ig products currently licensed in the U. Companies that manufacture Ig replacement therapy offer a wealth of valuable information for individuals and families living with PI.
This page contains general medical information which cannot be applied safely to any individual case. Medical knowledge and practice can change rapidly. Therefore, this page should not be used as a substitute for professional medical advice. The Immune Deficiency Foundation improves the diagnosis, treatment, and quality of life of people affected by primary immunodeficiency through fostering a community empowered by advocacy, education, and research.
Sign up for action alerts. Get peer support. Designed by BackOffice Thinking. Skip to main content. Immunoglobulin Ig Replacement Therapy. Ig replacement therapy is one of the most important and successful therapies for people with primary immunodeficiencies PI that affect antibody production. The therapy is both lifesaving and often lifelong, and it plays a vital role in the lives of many people with PI.
What Is Immunoglobulin Replacement Therapy? History Gamma globulin derived from human plasma was first introduced as a treatment option in when gamma globulin was injected intramuscularly IM to treat people with recurrent infections who had antibody immune deficiencies 1. Manufacturing There are more than 25 different Ig preparations available worldwide.
Safety There are multiple safety steps in the production of Ig: donor screening, viral removal, and inactivation of viruses. Some rare side effects include: Aseptic meningitis inflammation of the meninges, the membranes that surround the brain and spinal cord has been seen up to 72 hours after infusion of IVIG and may be more prevalent in people with a history of migraine headaches.
0コメント