The distribution between plasma and extravascular fluid is achieved quickly enough, and after 3-5 days an equilibrium is reached between the intravascular and extravascular spaces. The half-life of immunoglobulin contained in pentaglobin comparable half-life of immunoglobulin available to the body. The trenbolone acetate stack with half-life may vary from patient to patient, especially in the case of primary immunodeficiencies.
Immunoglobulin complexes of immunoglobulins and cells of the reticuloendothelial system utilized.
Treatment of bacterial infections while using antibiotics.
Replacement therapy in patients with immunodeficiency or severe secondary antibody deficiency syndrome (patients with immune deficiency or a suppressed immune defense).
: Hypersensitivity to any component of the formulation. Hypersensitivity to human immunoglobulin, particularly in rare cases, blood deficiency Class A immunoglobulin (IgA) and the presence of antibodies against IgA.
Pregnancy and lactation
No risk of the use of this drug during pregnancy has not been studied in controlled clinical trials, so during pregnancy and lactation should be used with caution, though long experience medical use of immunoglobulins does not allow to expect any harmful effect on pregnancy and the fetus and newborn. Introduced immunoglobulins are excreted in breast milk and may contribute to the transfer of protective antibodies to the newborn.
Dosage and administration
The dosage depends on the immune status of the patient and the severity of the disease. For orientation are the following dosage recommendations:
1. For newborns and infants: treatment of serious bacterial infections, replacement therapy in children with immunodeficiency and secondary antibody deficiency syndrome – daily 5 ml / kg body weight for 3 days in a row. The need to re-rate depends on the clinical course of the disease.
2. For children and adults:
a) the treatment of serious bacterial infections:. Daily 5 ml / kg body weight for 3 days in a row
need to re-rate depends on the clinical course of the disease.
B) replacement therapy in patients with immunodeficiency and secondary syndrome antibody deficiency: 3 to 5 ml / kg body weight.
If necessary, a second course after a week’s break.
The method of administration
Prior to administration Pentaglobin should be visually inspected for particulate matter and compliance with physical properties. Opaque or containing pellet was prohibited to use. Light Opalescence is property.
The contents of the opened ampoules or vials should be used immediately. Because of the risk of bacterial contamination unused solution must be discarded. Before opening the ampoule or vial preparation should be warmed to room temperature. Only be mixed with 0.9% sodium chloride solution for injection. Other agents can not be added to the solution trenbolone acetate stack with since changes in electrolyte concentration or pH can cause protein denaturation or precipitation.
Precautions for the use of
certain severe side effects may depend on the rate of administration, so you need to strictly abide by the speed of administration recommended in the “Dosage and Administration”.
Certain side effects may occur more often
- introducing at high speed,
- patients with gipoagammaglobulinemiey agammaglobulinemia or the presence or absence of IgA-deficiency
- patients receiving human immunoglobulin for the first time or, in rare cases when another immunoglobulin preparation, or if the treatment is carried out for a long time immunoglobulins.Hypersensitivity reactions in its true form is found in the very rare cases in which the blood is not an immunoglobulin A (IgA) and have antibodies to IgA.
In rare cases, as a result of the administration of immunoglobulin possible decrease in blood pressure and in rare cases – anaphylactic shock, even if the patient is the previous administration of the drug did not show hypersensitivity.
In most cases it is possible to avoid possible complications if
- ensure that the patient does not exhibit allergic reactions against human immunoglobulin, human immunoglobulin first introducing very slowly (0.4 ml / kg / hr)
- carefully watched during the entire administration of the drug for the patient and watch for signs of unwanted actions. Especially carefully it is necessary to watch for the whole infusion and for at least 1 hour after its completion in order to monitor trenbolone acetate stack with the possible emergence of side effect symptoms of patients never previously treated with human immunoglobulins, or treated to date other immunoglobulins or to which immunoglobulin is administered for a long time . All other patients should be observed for at least 20 minutes after administration.
In patients with immunoglobulin may occur very rarely cases of acute renal failure.In most cases, this side effect occurred in patients who have additional risk factors: existing renal dysfunction, diabetes, low blood volume, overweight, medications that have nephrotoxicity, and age older than 65 years.In appointing the drug and conduct immunoglobulin treatment for all groups of patients should:
- sufficient fluid intake prior to the infusion of immunoglobulin,
- monitoring the amount of urine
- control of the content of serum creatinine (an indicator of kidney function)
- waiver of the simultaneous reception of diuretics
In case of adverse effects on renal function should consider discontinuing administration of immunoglobulin.
The most common renal dysfunction and acute renal failure associated with the use of products containing sucrose as a stabilizer.Therefore, patients with any risk factor recommended immunoglobulins that do not contain sucrose, such as Pentaglobin.In addition, immunoglobulin preparations to be administered is not to exceed the speed limit (0.4 ml / kg / hour).Vehicle and mechanisms management
There are no indications that immunoglobulins can affect the ability to drive or maintain mechanisms.
Possible side effects such as a fever, headache, fever, nausea, vomiting, allergic reactions, arthralgia and mild back pain. In rare cases, as a result of the administration of immunoglobulin possible sudden drop in blood pressure and in rare cases – anaphylactic shock, even if the patient is under the previous administration of the drug did not show increased sensitivity. In connection with the introduction of immunoglobulins were observed cases of the appearance of symptoms of aseptic meningitis and in rare cases, haemolytic anemia / haemolysis and transient skin reactions (rash or redness), which completely disappeared after discontinuation of therapy. Also, there was an increase of serum creatinine and / or acute renal failure.
In a few cases showed signs of thrombosis in elderly patients, in patients with signs of cerebral or cardiac ischemia (impaired blood supply to brain or heart), and in patients who are overweight or severe hypovolemia.
In the event of intolerance reactions necessary either to reduce the speed of injection, infusion or suspend it until symptoms disappear. Selection of appropriate actions depending on the type and severity of side effects. In the case of negative effects on kidney function immunoglobulin therapy should be discontinued.
In the event of a shock, it is necessary to follow the current guidelines for the anti-shock therapy.
In the application of medicinal preparations from human blood or plasma as a result of transmission of infectious agents infecting the latter can not be completely excluded. This applies to pathogens of hitherto unknown nature. To reduce the risk of transmission of pathogens, according to strict criteria for donor selection is carried out, tested and selected donor plasma and the plasma is controlled by the pool. The manufacturing process includes the stage for the removal and / or inactivation of pathogens (see. “Additional information”).
An overdose of the drug trenbolone acetate stack with in patients belonging to risk groups, especially among older persons, as well as in patients with impaired renal function, may lead to fluid overload (increased blood volume) and increasing blood viscosity.
Interaction with other drugs
- Pentaglobin can not be used in conjunction with calcium gluconate, as it is suspected that infants simultaneous use can cause adverse effects. Live virus vaccines: the introduction of immunoglobulin may adversely affect at least 6 weeks and up to 3 months the efficacy of live vaccines for viral diseases such as measles, rubella, mumps and chicken pox. Vaccination with the appropriate live vaccine should be carried out not earlier than after 3 months after administration Pentaglobin. In the case of vaccination against measles immunoglobulin similar effect can last up to 1 year. Prior to the expiration of this period, measles vaccine should be carried out after determining whether the patient has the relevant antibodies. Laboratory investigations: after the administration of immunoglobulin possible temporary rise in titer of various passive administration of antibodies that can lead to false positive data analysis for serological study. Passive administration of antibodies against antigens of red blood cells (such as A, B, D) may affect the individual serological parameters such as alloantibodies to erythrocytes (e.g., Coombs’ test), haptoglobin and reticulocyte count.