Drug Class – Immunoglobulins
Common Examples – Privigen, Cytogam, RhoGAM, HepaGam B, Octagam,
Mechanism of Action (MOA) – The exact mechanism of action of immunoglobulins is unknown however it is known to researchers and medical professionals that immunoglobulins suppress the immune response of Rh- negative pts. to Rh- positive red blood cells as well as reestablishing normal immunoregulatory pathways (Epocrate).
Side Effects of MOA – Octagam and Privigen both have black box warnings however this black box warning does not apply to all Immunoglobulins. The black box warning consists of increased risk of acute renal dysfunction/failure as well as thrombosis. The risk of thrombosis is increased in patients over the age of 65 years old, prolonged immobilization, etc. (Epocrate). Other serious side effects include hypersensitivity, anaphylaxis, erythema multiforme, hyperproteinemia, hyperviscosity, aseptic meningitis, pseudohyponatremia, viral transmission risk, and hemolytic anemia (Epocrate).
Teaching – It is common for the patient to experience headache, cough, nausea and vomiting, rash, uricaria, fever, rigors, flushing, back pain, fatigue, chest tightness, muscle cramps, and elevated BUN Cr elevated lab values (Epocrate). It is important to alert your doctor of any allergy before beginning to take these medications. Do not get any type of immunization while taking immunoglobulins without getting an okay from your doctor (MayoClinic).
Administration Consideration (Special timing, take with/without food, etc.) – It is important to take this medication on a very regular schedule as well as making sure to take the medication with food. There is a serious risk of anaphylaxis with these medications so the importance of telling your doctors your allergies is very great (MayoClinic).
Drug/Drug Interactions (Major – prioritizing most concerning) – Consult your doctor if you are on any medications for heart problems, blood clotting, or
References: Epocrates. (2012-2014) Drugs: Immunglobulins– subclasses. KidsHealth. (2014.) From Nemours: Blood tests for immunoglobulins IgA, IgE, IgM. [pdf.] Retrieved from http://kidshealth.org/parent/system/medical/test_immunoglobulins.html MayoClinic. (2013.) Mayo Foundation for Medication and Medical Research: The use of Drugs and supplements. Immunoglobulins. [pdf.] Retrieved from http://www.mayoclinic.org/drugs-supplements/immune-globulin-intramuscular-route-intravenous-route-subcutaneous-route/precautions/drg-20067720