Botulism Immune Globulin (Intravenous-Human)

Mechanism :

It is derived from the pooled plasma of individuals who have a high titre of neutralising antibodies against the neurotoxins A and B produced by botulinum. It provides passive immunity. Derived from the plasma of adults immunized with botulinum toxoid types A and B. Provides antibodies to neutralize circulating toxins.

Indication :

• Infant botulism

Contraindications :

• Hypersensitivity

• Hypovolemia

• Caution in case of IgA deficiency, renal impairment, diabetes mellitus, risk of sepsis/thrombosis, paraproteinemia, hyperviscosity syndrome, inflammatory disorders

Dosing :

Adverse Effect :

• Common: transient increase/decrease in BP, pallor, edema, heart murmur, irritation, increase /decrease in body temperature, diarrhea, vomiting, abdominal distension, contact dermatitis/erythematous rash, otitis media, atelectasis, cough, rales, rhonchi, decrease in oxygen saturation, nasal congestion

• Uncommon: injection site erythema, local reaction at injection site, infusion rate reaction, tachycardia, peripheral coldness, decrease in hemoglobin, dehydration, hyponatremia, metabolic acidosis, neurogenic bladder, difficulty breathing, increased respiratory rate, decreased breath sounds, stridor, LRTI, oral candidiasis, central nervous system agitation

Interaction :

• Serious: adefovir, amphotericin b, amikacin, bacitracin, capreomycin, celecoxib, cisplatin, cyclosporin, cidofovir, defrasirox, diclofenac, foscarnet, fenoprofen, gentamicin, ibuprofen, indomethacin, kanamycin, ketorolac, lithium, methotrexate, mesalamine, meclofenamate, naproxen, neomycin, pentamidine, phenylbutazone, polymyxin b, sirolimus, sulfasalazine, streptomycin, tacrolimus, tenofovir, tobramycin, vancomycin

• Requiring close monitoring: live/attenuated vaccines, exenatide, fosphenytoin, phenytoin