Product Details

 Action Directly neutralizes rabies virus.

 Indications Passive, transient postexposure prevention of rabies infection in susceptible individuals.

 Contraindications Repeated doses once vaccine treatment has been initiated. RIG may theoretically be contraindicated in persons who have had life-threatening reactions to human IgG antibody products or any RIG components. Previous complete immunization with rabies vaccine and presence of adequate antibody titer.

 Route/Dosage

ADULTS & CHILDREN: IM 20 IU/kg (0.133 ml/kg) as soon as possible after exposure, preferably with first dose of vaccine.

 Interactions

Measles, mumps, polio, or rubella live vaccines: Other antibodies in RIG preparation may interfere with response to these live vaccines.

 Lab Test Interferences None well documented.

 Adverse Reactions

DERM: Urticaria; skin rash. GU: Nephrotic syndrome. OTHER: Local tenderness, soreness, or stiffness at injection site; low-grade fever; angioedema; sensitization to repeated injections; anaphylactic shock.

 Precautions

Pregnancy: Category C. Use only if clearly needed. Lactation: Unknown. Hypersensitivity to thimerosal or human immunoglobulins: Give drug with caution. Live vaccines: To avoid inactivating live vaccines, do not give live vaccines within 4 mo after RIG.

 Administration/Storage

• Use up to ½ dose to infiltrate wound site if nature and location of wound site permits. Administer balance of dose IM at different site and in different extremity from rabies vaccine, preferably in gluteal muscle (upper, outer quadrant only) or deltoid muscle.
• Administer as soon as possible after exposure up to 8 days after first vaccine dose.
• RIG is used in conjunction with rabies vaccine. Administer human diploid cell culture (HDCV) rabies vaccine as soon as possible after rabies exposure.
• Do not give more than 5 mL in one injection site.
• Store under refrigeration; do not freeze.

 Assessment/Interventions

• Obtain complete history, including drug history, and any known allergies. Verify that prior vaccine treatment has not been initiated and that hypersensitivity to human immune globulins and thimerosal (chemical found in contact lens solutions) does not exist.
• Assess for signs of immediate (within 15 min) and delayed allergic reaction: shortness of breath, rash, pruritus, and fever. Report symptoms to physician immediately.
• Note date of last tetanus immunization. Vaccinate if needed.

 Patient/Family Education

• Advise patient that pain, itching, and swelling may temporarily occur at injection site.
• Advise patient to take acetaminophen to alleviate headache, fever, and pain.
• Teach patient wound care and signs of infection (eg, fever, wound drainage, increased pain at wound site) if applicable prior to discharge.
• Encourage patient to return for medical follow-up within 7 to 10 days after discharge.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
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