Vaccinia Immune Globulin (VIG-IV) (vac-cin′i-a)
Classifications: BIOLOGIC RESPONSE MODIFIER; IMMUNOGLOBULIN
Therapeutic: IMMUNOGLOBULIN
Prototype: Immune globulin
ACTION & THERAPEUTIC EFFECT
Vaccinia immune globulin, VIG (VIGIV) is a
purified human immunoglobulin G (IgG). It is derived from adult human plasma
collected from donors who received booster immunizations with the smallpox
vaccine. VIG (VIGIV) contains high titers of antivaccinia antibodies. VIG is effective in the treatment of smallpox
vaccine adverse reactions secondary to continued vaccinia virus replication
after vaccination.
Prevention of serious complications of smallpox
vaccine; treatment of progressive vaccinia; severe generalized vaccinia; eczema
vaccinatum; vaccinia infection in patients with skin conditions (e.g., burns,
impetigo, varicella-zoster, poison ivy, or eczematous skin lesions); treatment or
modification of aberrant infections induced by vaccinia virus.
Predisposition to acute renal failure (i.e., preexisting
renal insufficiency, DM, volume depletion, sepsis proteinemia, patients older
than 65 y); AIDS; chronic skin conditions; bone marrow suppression;
chemotherapy; radiation therapy; corticosteroid therapy, eczema; hematologic
disease, thrombosis; hypotension; herpes infection; postvaccinal encephalitis; aseptic
meningitis syndrome (AMS); pulmonary edema; lactation.
Renal impairment; autoimmune disease;
cardiomyopathy, impaired cardiac output, cardiac disease, history of
hypercoagulation; pregnancy (category C). Safe use in children not established.
Renal Impairment Dosage Adjustment
PREPARE: IV Infusion: No dilution required. Use solution as supplied.
ADMINISTER:
IV Infusion: Begin
infusion within 6 h of entering the vial. Complete infusion within 12 h of
entering the vial.
- Use
inline filter (0.22 microns), infusion pump, and dedicated IV line [may infuse into
a preexisting catheter if it contains NS, D2.5W, D5W, D10W, or D20W (or any
combination of these)].
- Infuse at
1 mL/kg/h the first 30 min, increase to 2 mL/kg/h the next 30 min, and then
increase to 3 mL/kg/h until infused.
Body as a Whole: Injection site reaction. CNS: Dizziness, headache. GI: Abdominal
pain, nausea, vomiting. Musculoskeletal: Arthralgia, back pain. Respiratory: Upper respiratory infection. Skin: Erythema, flushing.
Drug: May interfere with the immune response to LIVE VIRUS VACCINES. Vaccination with LIVE VIRUS VACCINES should be deferred until approximately 6 mo after
administration of VIG-IV.
Vaccinia immune
globulin IV has been associated with serious renal dysfunction, acute renal
failure, and death.
Assessment & Drug Effects
- Monitor vital signs continuously during
infusion, especially after infusion rate changes.
- Slow infusion rate for any of the following:
Flushing, chills, muscle cramps, back pain, fever, nausea, vomiting,
arthralgia, and wheezing.
- Discontinue infusion, institute supportive
measures, and notify prescriber for any of the following: Increase in heart rate,
increase in respiratory rate, shortness of breath, rales or other signs of
anaphylaxis.
- Have loop diuretic available for management of
fluid overload.
Patient
& Family Education
- Promptly report any discomfort that develops
while drug is being infused.
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