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Intravenous Immunoglobulins (IVIGs)

Intravenous Immunoglobulins (IVIGs) may be used to control SLE with organ involvement or vasculitis. Although the mechanism by which these products help is not well-understood, it is thought that they reduce antibody production or promote the clearance of immune complexes from the body.

Risks

Although an IVIG, like any drug, can cause potentially dangerous side effects, it doesn’t suppress the immune system the way immunosuppressives and corticosteroids do. Thus, the risk of serious infections with these drugs is less.

Side/Adverse Effects

Dermatologic: rash, mild skin reaction at injection site

Gastrointestinal: abdominal cramps, nausea, vomiting

Musculoskeletal: chest, back or hip pain; muscle pain; joint pain

Neurologic: anxiety, chills, dizziness, fever, headache

Other: chest tightness, difficulty breathing, burning sensation in the head


Considerations for Health Professionals

Assessment:

History: allergy to Igs; sepsis; volume depletion; IgA deficiency; paraproteinemia; renal insufficiency; diabetes mellitus; methotrexate; and virus vaccines

Laboratory data: CBC; white blood cell differential count; renal function studies, including measurement of blood urea nitrogen (BUN)/serum creatinine; liver function tests; pulmonary function tests; chest X ray; and electrocardiogram (ECG)

Physical: all body systems, to determine baseline data and alterations in function; temperature; pulse; respiration; weight; skin color; lesions; hair; and mucous membrane

Evaluation:

therapeutic responses and adverse effects

Administration:

Intravenously. The dose is 400 mg/kg for 5 days. The nurse must work closely with the prescribing physician to administer the drug safely and to monitor the patient to minimize adverse effects and achieve expected outcomes. Some patients experience headaches that can be helped by slowing the infusion.

Teaching Points:

See Patient Information Sheet on Intravenous Immunoglobulins (IVIGs).




Source: National Institutes of Health, U.S.Dept of Health and Human Services



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