Diptheria Immeune Globulin

Indications
 Intravenous
Mild to moderate nasal diphtheria
Adult: 10 000-20 000 units via slow IV infusion.
Intravenous
Mild to moderate tonsillar diphtheria
Adult: 15 000-25 000 units via slow IV infusion.
Intravenous
Mild to moderate pharyngeal or laryngeal diphtheria
Adult: 20 000-40 000 units via slow IV infusion.
Intravenous
Mild to moderate cutaneous diphtheria
Adult: Only used if ulcer >2 cm2 (insufficiently absorbed in smaller ulcers). Dose: 20 000-40 000 units by slow IV infusion.
Intravenous
Severe diphtheria
Adult: Up to 100 000 units by slow IV infusion.
Intradermal
Diphtheria hypersensitivity test
Adult: 0.1 ml of diphtheria antitoxin (equine) in 0.9% sodium chloride in a 1:100 dilution. Skin test read 20 minutes later. If patient has a history of allergy: 0.05 ml of a 1:1000 dilution. An inj of 0.9% sodium chloride can be used as a control. A positive reaction is represented by an urticarial wheal, with or without pseudopods, with a zone of erythema.
Subconjunctival
Diphtheria hypersensitivity test
Adult: 1 drop of a 1:10 dilution of equine diphtheria antitoxin administered to lower conjunctival sac of 1 eye, control test of 0.9% sodium chloride administered to other eye. Test read after 15 minutes. A positive test is represented by ocular itching, burning, redness and lacrimation which can be relieved by applying 1 drop of ocular epinephrine solution on the affected eye.
Subcutaneous
Desensitisation of diphtheria hypersensitivity
Adult: Diphtheria antitoxin (equine) is administered in incremental doses every 15 minutes: 0.05 ml of a 1:20 dilution, 0.1 ml of 1:10 dilution, 0.3 ml of a 1:10 dilution and 0.1 ml of undiluted antitoxin. After another 15 minutes, 0.5 ml of undiluted antitoxin is administered IM or IV.
Topical/Cutaneous
Scratch skin test for diphtheria hypersensitivity
Adult: 1 drop of a 1:100 dilution of equine diphtheria antitoxin placed on the skin and then a 0.64 cm scratch made through the drop. A control of 0.9% sodium chloride can be used. Test read after 20 minutes. A positive reaction is represented by an urticarial wheal, with or without pseudopods, with a zone of erythema.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 History of asthma. Test doses should be administered before immunisation to eliminate hypersensitivity. Adrenaline inj and resuscitation facilities should be available after all immunisation. Not used for diphtheria prophylaxis because of hypersensitivity risk. A negative sensitivity test dose so not completely exclude systemic sensitivity. If hypersensitivity occurs during or immediately after desensitisation procedure, a tourniquet should be applied and adrenaline administered next to the site of inj.
Adverse Reactions
 Serum sickness (type III hypersensitivity reaction) up to 12 days after antitoxin admin, symptoms include: Urticaria, fever, pruritus, malaise, skin rash and arthralgia. Accelerated serum sickness (occurring <7 days after immunisation) may occur in individuals with previous admin of equine serum.
Potentially Fatal: Anaphylactic reactions (type I hypersensitivity reaction): Sudden onset of urticaria, respiratory distress, hypotension, shock and vascular collapse.
Mechanism of Actions
 Diptherias antitoxin is used, often concurrently with an antibiotic, for passive immunisation against suspected diphtheria infection. It contains specific globulins which negate the local and systemic effects of toxins produced by Corynebacterium diptheriae.
Storage Conditions
 Intradermal: Store at 2-8 °C, do not freeze. Intravenous: Store at 2-8 °C, do not freeze. Subconjunctival: Store at 2-8 °C, do not freeze. Subcutaneous: Store at 2-8 °C, do not freeze. Topical/Cutaneous: Store at 2-8 °C, do not freeze.
ATC Classification
 J06AA01 - diphtheria antitoxin ; Belongs to the class of immune sera. Used in the treatment of acute infectious diseases caused by toxigenic strains.
Storage
 Intradermal: Store at 2-8 °C, do not freeze. Intravenous: Store at 2-8 °C, do not freeze. Subconjunctival: Store at 2-8 °C, do not freeze. Subcutaneous: Store at 2-8 °C, do not freeze. Topical/Cutaneous: Store at 2-8 °C, do not freeze.
Available As
  • Diptheria Immeune Globulin –
  • Diptheria Anti Antitoxin (Serum) 10000 iu

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