Description of Sera and Immunoglobulin
Session 45: Description of Sera and Immunoglobulin
Total Session Time: 120 minutes
Prerequisites
Learning Tasks
By the end of this session students are expected to be able to:
Resources Needed:
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation/
2 20 minutes Indications of Sera and Immunoglobulin
Buzzing
Presentation/
3 10 minutes Contraindication of Sera and Immunoglobulin
brainstorming
Dose, Dosage and Course of Sera and
4 40 minutes Presentation
Immunoglobulin
Presentation/ Side Effects and Adverse Effects of Sera and
5 20 minutes
brainstorming Immunoglobulin
Interaction and Precaution of Sera and
6 05minutes Presentation
Immunoglobulin
7 10 minutes Presentation Key Points
8 10 minutes Presentation Evaluation
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
288
SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing.
STEP 2: Indications of Sera and Immunoglobulin (20 minutes)
Activity: Buzzing (5 minutes)
ASK students to pair up and buzz on the following questions for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
WRITE their response on the flip chart/board
CLARIFY and SUMMARIZE by using the content below
Definition
o Refers to purified and concentrated preparations of serum of horses actively
immunized against a specific antigen
o Example are Tetanus antitoxin (ATS), Gas gangrene antitoxin (AGS), Diphtheria
antitoxin (ADS), Antirabies serum (ARS) and Antisnake venom polyvalent
o Refers to a separated human gamma globulins which carry the antibodies
o They are more efficacious than the corresponding antisera
o Example are normal human gamma globulin, Anti-D immunoglobulin, Tetanus
immunoglobulin, Rabies immuneglobulin and Hepatitis-B immunoglobulin
Indications
o Indications for its use are viral hepatitis A and B (prophylaxis), measles, mumps,
poliomyelitis and chickenpox (prophylaxis and modification of course of illness), and
has some beneficial action in burns
It is especially valuable in agammaglobulinemia, premature infants and in patients
of leukemia or those undergoing immunosuppression
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
289
o Prevention of Rho(D) sensitisation to rhesus negative woman
o Post-exposure prophylaxis against rabies infection
o Treatment of bleeding episodes
o Treatment of bleeding episodes
o Snake bite/Poisoning
o Post-exposure prophylaxis and treatment of tetanus infection
Indicated for prophylaxis in non-immunized persons receiving a contaminated
wound who are at high risk of developing tetanus
STEP 3: Contraindications of Sera and Immunoglobulin (10 minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
o Patients with a history of allergic reactions after administration of human
immunoglobulin preparations
o Individuals with isolated immunoglobulin A (IgA) deficiency (individuals could have
an anaphylactic reaction to subsequent administration of blood products that contain
IgA)
o Patients with hypersensitivity to horse serum or any other component of the serum
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
290
STEP 4: Dose, Dosage and Course of Sera and Immunoglobulin
(40 minutes)
o Available as Gamma – Globulins Injection I.V 500mg, 2.5g and 5g
o Hereditary haemolytic anaemia
o Idiopathic thrombocytopenic Purpura (ITP) for the emergence of acute bleeding
caused by severe thrombocytopenia
followed immediately platelets transfusion Splenectomy
o Dose by deep intramuscular injection, to rhesus-negative woman for prevention of
Rho(D) sensitisation;
Following birth of rhesus-positive infant: 500 units immediately or within 72
hours
fetal red cells
Following any potentially sensitising episode (e.g. stillbirth, abortion,
amniocentesis) up to 20 weeks‘ gestation . 250 units per episode (after 20 weeks,
500units) immediately or within 72 hours
Antenatal prophylaxis 500 units given at weeks 28 and 34 of pregnancy; if infant
rhesus-positive, a further dose is still needed immediately or within 72 hours of
delivery
transfused rhesus-positive red cells
o Available as Anti-rabies Immunoglobulin Injection 1000 IU/5ml ampoule
o Passive immunization of rabies
the other half injected into and around the wound
o Active immunization of rabies
Rabies immunoglobulin with the first dose (day 0) Tetanus toxoid vaccine
Refer students to Handout 31.1: Management of rabies for exposed individuals for
further reading
o Treatment of bleeding episodes
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
291
o Available as Powder for reconstitution 2mg
o Treatment of bleeding episodes
o Available as Snake venom polyvalent Antiserum injection
Dose: 20ml i.v. (1 mil/min injection) repeated at 1 to 6 hourly intervals till symptoms
o Available as Tetanus Immunoglobulin (human) – ATS Injection 1,500 IU in vial;
Tetanus Immunoglobulin Tetanus Immunoglobulin (human) – ATS Injection 10,000
I.U in vial; Tetanus Immunoglobulin Tetanus Immunoglobulin (human) – ATS
Injection 100,000 I.U in vial and Tetanus Immunoglobulin Tetanus Immunoglobulin
(human) – ATS Injection 500,000 I.U in vial
o For prevention of further absorption of toxin form wound
o Wound care
Tetanus prophylaxis
immunization protocol, see table 39.1)
Table 39.1: Protocol in Provision of Tetanus Prophylaxis
Patient Category Non-tetanus Prone Tetanus Prone
Immunized and booster Nil Nil
within 5 years
Immunized and 5 to 10 Nil TT
years since booster
Immunized and >10 years TT TT
Incomplete immunization TT and TIG TT and TIG
or unknown
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
292
STEP 5: Side Effects and Adverse Effects of Sera and Immunoglobulin
(20 minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
o Immediate type of allergic reactions (urticaria, angioedema, respiratory distress and
anaphylaxis) can occur with any antiserum
o Serum sickness with fever, rash, joint pain, lymphadenopathy appearing 7-12 days
later is more frequent after large doses and repeated administration
o Local pain, erythema and arthus type reaction without constitutional symptoms may
also occur 7-70 days after i.m. injection
o Side-effects
Injection site swelling and pain; very rarely anaphylaxis; buccal ulceration,
glossitis, chest tightness, dyspnoea, tremor, dizziness, arthralgia, and facial
oedema
o Side effects
Injection site swelling and pain; rarely anaphylaxis
o Side-effects
Nausea, vomiting, diarrhoea, abdominal pain; hypotension, hypertension,
headache, fever, malaise, asthenia, drowsiness, dizziness, back pain, arthralgia,
myalgia; pruritus, rash, sweating, injection site pain; rarely tachycardia,
anaphylaxis, dyspnoea, hypotension, and urticarial
o Allergic reactions includes anaphylactic shock, to the serum are possible
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
293
STEP 6: Interaction and Precaution of Sera and Immunoglobulin
(5 minutes)
o The immune globulins and antisera are administered cautiously during pregnancy
(Pregnancy Category C) and lactation and in children
o Antibodies in the immune globulin preparations may interfere with the immune
response to live virus vaccines
STEP 7: Key Points (10 minutes)
o Refers to purified and concentrated preparations of serum of horses actively
immunized against a specific antigen
o Refers to a separated human gamma globulins which carry the antibodies
o They are more efficacious than the corresponding antisera
(Pregnancy Category C) and lactation and in children
vaccines
STEP 8: Evaluation (10 minutes)
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
294
References
Ministry of Health and Social Welfare. 2013(2013). Standard Treatment Guidelines &
National Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam,
Tanzania government printers.
Pharmacotherapy: A Pathophysiologic Approach (9th ed.). New York, McGraw-Hill
Education.
Sally S.R., & Jeanne C.S. (2000). Introductory Clinical Pharmacology (6th ed) New York,
Lippincott Williams and Wilkins.
School of Pharmaceutical sciences. (2011).Tanzania Pharmaceutical Handbook (2nd ed.).
Dar es Salaam, ARDHI University press.
The Royal Pharmaceutical Society of Great Britain. (2007). Martindale, the Extra
Pharmacopoeia (5TH ed). London, pharmaceutical press.
The Royal Pharmaceutical Society of Great Britain. (2009). British National Formulary
(59th ed). London, BMJ Group and RPS Publishing.
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
295
Handout 32.1: Management of rabies for exposed individuals
Category Management
CATEGORY I No treatment
Touching or feeding animals, licks on
the skin
CATEGORY II After washing the wound with running water and
Nibbling of uncovered skin, minor soap for 15 minutes, administer antirabies vaccines
bleeding, licks on broken skin one hand and another 0.1ml on the deltoid of the
second hand on days 0, 3, 14 and 28
OR
28 Note:
Children are given the same doses but vaccine is
administered on the lateral part of the thigh.
CATEGORY III After washing the wound with running water and
Single or multiple transdermal bites soap for 15 minutes, administer Rabies
with saliva from licks; exposure to Human (HRIG) Administer antirabies vaccines –
one hand and another 0.1ml on the deltoid of the
second hand on days 0, 3, 14 and 28
OR
28
Note 1: Children are given the same doses but
vaccine should be administered on the lateral part of
the thigh.
Note 2: The World Health Organization
recommends ID route of vaccination administration
because it is cost effective.
PST 04211 Basic Pharmacology NTA Level 4 Semester 2 Facilitator Guide
296
Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP
