RESPIRATORY SYNCYTIAL VIRUS IMMUNE GLOBULIN (RSV-IVIG)
| RESPIRATORY SYNCYTIAL VIRUS IMMUNe GLOBULIN (RSV-IVIG) (res-pir'a-tory sin-cy'ti-al) RespiGam Classifications: biologic response modifier; immunoglobulin; Therapeutic: immunoglobulin Prototype: Immune globulin Pregnancy Category: C |
Availability
2500 mg/50 mL vial
Action
Contains IgG immune globulin antibodies from human plasma.
Therapeutic Effect
The preparation contains large amounts of RSV-neutralizing antibodies.
Uses
Prevention of serious lower respiratory tract infection caused by RSV in children <24 mo with bronchopulmonary dysplasia or history of premature birth; hypervolemia.
Contraindications
Previous severe reaction to RespiGam or other human immunoglobulin preparation, selective Iga deficiency; congenital heart disease, fluid overload; hepatic disease, pregnancy (category C).
Cautious Use
Immunodeficiency, AIDS, pulmonary disease; CHF; renal failure.
Route & Dosage
| RSV Child/Infant/Neonate: IV 750 mg/kg infused at 1.5 mL/kg/h for first 15 min, then 3 mL/kg/h for next 15 min, then 6 mL/kg/h for rest of infusion, may repeat monthly as needed |
Administration
| Intravenous PREPARE: IV Infusion: Give undiluted. ADMINISTER: IV Infusion: Do not shake vial; infuse vial contents undiluted through a separate IV line if possible; if "piggyback" must be used, see manufacturer's directions. DO NOT EXCEED IV INFUSION RATES given in Route & Dosage table! Use a constant infusion pump. INCOMPATIBILITIES Solution/additive or Y-site: Do not mix with other drugs. |
- Store vials at 2°–8° C (35°–46° F). Begin infusion within 6 h after vial is entered and complete within 12 h.
Adverse Effects (≥1%)
Body as a Whole: Fever, pyrexia, fluid overload. CV: Tachycardia, hypertension. GI: Vomiting, diarrhea, gastroenteritis. Respiratory: Respiratory distress, wheezing, rales, hypoxia, hypoxemia, tachypnea. Skin: Injection site inflammation.Interactions
Drug: May interfere with immune response to live virus vaccines (mumps, rubella, measles), may need to repeat vaccine if given within 10 mo of RespiGam.Pharmacokinetics
Half-Life: 22–28 d.Nursing Implications
Assessment & Drug Effects
- Monitor closely during and after each IV rate change.
- Assess vital signs and respiratory status prior to infusion, during and after each rate change, and at 30-min intervals until 30 min after infusion is completed, and periodically thereafter for 24 h.
- Slow infusion immediately if S&S of fluid overload appear and report to physician.
- Lab tests: Monitor routine blood chemistry, serum electrolytes, blood gases, osmolality.
- Monitor for aseptic meningitis syndrome, which may begin up to 2 d after infusion.
Patient & Family Education
- Be aware of the possibility of aseptic meningitis syndrome; learn S&S to report (headache, drowsiness, fever, photophobia, painful eye movements, muscle rigidity, nausea, vomiting).
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug