Friday, October 9, 2015

Bug's Out- Patient IVIG Treatment

Today is October 9, 2015.
Mom and Bug were up early this morning for an hour long drive in early morning traffic for Bug's first out patient IVIG treatment....

You may be asking what is IVIG?  How is it suppose to help?

Let me answer those questions for you.

IVIG stands for Intravenous Immunoglobulin
Intravenous- IV
Immunoglobulins- are plasma proteins secreted by plasma cells, forming a major component of the adaptive immune system. 

**Immunosuppressive therapy has played a very important

role in reducing mortality rates and morbidity in JM patients.

IVIG is a blood product prepared from plasma, each batch prepared from a pool of 10 000–20 000 donations. Multiple purification steps during the manufacturing process aim to eliminate all known transmissible pathogens, but cannot completely exclude the risk from unknown pathogens.

** So you see not only does Bug and the other children effected with this disease have to deal with the effects AND complications of the disease itself, but also the possible effects of their treatment**


Intravenous Immune Globulin

– Immune Globulin – antibody, protein, Y-shaped,
protect from foreign invaders – most common is
– Found in blood plasma
• Human donors – it takes THOUSANDS to make just ONE DOSE
• Plasma is treated to deactivate any potential viral
• Plasma is purified so that contents are as much IgG as
possible and minimize other plasma contents

How is it administered?
• Usually through a vein in your arm
• If you have difficulty with IV access, central
line in chest is an option – more long term
• Slowly – most reactions occur when it is run
too quickly
– Infusion rates are specific to each individual
– Package insert is the maximum rates for anyone,
but side effects tend to decrease the more slowly
it is infused
How is the dose determined?
• By weight and diagnosis
Someone with myositis is typically prescribed
2 grams per kilogram.
80 kg person = 160 grams
This would likely be broken up into 4 days of
40 gram each day
40 grams each day should take about 3-5 hours
depending on:
– MD orders
– Any prior treatment with IVIG and how it was
– How the individual actually tolerates IVIG when
– What the package insert for the brand used says

– Any rate restrictions for cardiac or renal issues

What are the side effects of IVIG?
Severe adverse reactions
• Anaphylaxis
• Renal Failure
• Thrombotic Event
• Aseptic Meningitis
• Hemolytic Anemia

Infusion-related reactions
• Headache
• Blood pressure changes
• Nausea
• Vomiting
• Dizziness
• Fever
• Fatigue
• Chills

How does it work?
• Not completely understood, there are many theories
• Myositis is thought to be autoimmune disease
– Autoimmune disease is where the immune
systems perceives part of the body as foreign and
attempts to destroy it
– IVIG suppresses the immune response
– IVIG has anti-inflammatory properties

Normally the drip of the IVIG is set for a 4 hour OR 8 hour session. 
Meaning it takes that long to be completely administered.
That"s a very LONG time for anyone, imagine for a 6 yr old. She has to stay still, hooked up to the pump as well as heart rate and pulse monitored.

Bug is a very DETERMINED, BRAVE, and STRONG little girl
As you can see in the pics.. At first they were using her right arm, however, she blew a vein and they had to move over to the left arm and start over.

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