Lymphocyte immune globulin, anti-thymocyte globulin (equine) sterile solution[ (Atgam) ] Drug Information

Contains Lymphocyte immune globulin, anti-thymocyte globulin (equine) sterile solution drug information and provides Lymphocyte immune globulin, anti-thymocyte globulin (equine) sterile solution drug indication, contraindication, special concerns, side effects, overdose management and dosage
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Management of allograft rejection in renal transplant clients, given either at the time of rejection or as an adjunct with other immunosuppressants to delay onset of the first rejection episode. Treatment of moderate to severe aplastic anemia in those who are unsuitable for bone marrow transplantation.
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In those who have demonstrated a severe systemic reaction during prior administration of the drug or any other equine gamma globulin preparation.
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Special Concerns:
A systemic reaction, such as a generalized rash, tachycardia, dyspnea, hypotension, or anaphylaxis, precludes any further administration of the drug. Potency may vary from lot to lot. The possibility of transmission of infectious agents exists. Use with caution during lactation.
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Side Effects:
General side effects. Whole body: Fever, chills, systemic or localized infection, malaise, serum sickness, edema, sweating. GI: N&V, diarrhea, GI bleeding or perforation sore mouth or throat, epigastric or stomach pain, abdominal pain. CNS: Headache, seizures confusion, disorientation, dizziness, faintness, paresthesias. CV: Hypertension or hypotension, tachycardia, deep vein thrombosis, thrombophlebitis, CHF, vasculitis, renal artery thrombosis. Hematologic: Thrombocytopenia, leukopenia, eosinophilia, neutropenia, granulocytopenia, anemia, lymphadenopathy, aplasia, pancytopenia, hemolysis, hemolytic anemia. Dermatologic: Rashes. Respiratory: Dyspnea, apnea, cough, pulmonary edema nosebleed. Musculoskeletal: Chest, back, or flank pain; arthralgia, myalgias, leg pains, abnormal involuntary movement or tremor, rigidity. Miscellaneous: Herpes simplex infection, swelling or redness at infusion site, swelling, anaphylaxis, laryngospasm/edema hyperglycemia, acute renal failure viral hepatitis, enlarged or ruptured kidney.

When used for renal transplantation with other immunosuppressants. Whole body: Fever, chills, weakness or faintness. CNS: Headache, dizziness, paresthesia, seizures. GI: Diarrhea, nausea and/or vomiting, stomatitis, hiccoughs, epigastric pain, malaise. Hematologic: Leukopenia, thrombocytopenia. Dermatologic: Rash, pruritus, urticaria, wheal, flare. CV: Hypotension, peripheral thrombophlebitis, edema, hypertension, renal artery stenosis, tachycardia. Musculoskeletal: Arthralgia, chest or back pain (or both), myalgia. Respiratory: Dyspnea, laryngospasm, pulmonary edema. Miscellaneous: Clotted arteriovenous fistula, pain at infusion site, night sweats, anaphylaxis herpes simplex reactivation, hyperglycemia, iliac vein obstruction, localized infection, lymphadenopathy, serum sickness, systemic infection, toxic epidermal necrosis wound dehiscence.

When used for aplastic anemia with support therapy. Whole body: Fever, chills, diaphoresis, aches. GI: N&V, diarrhea. CNS: Headache, agitation, lethargy, listlessness, lightheadedness, seizures encephalitis or postviral encephalopathy. CV: Chest pain, phlebitis, bradycardia, myocarditis, cardiac irregularity, hypotension, CHF, hypertension. Hematologic: Lymphadenopathy, postcervical lymphadenopathy, tender lymph nodes. Respiratory: Bilateral pleural effusion, respiratory distress. Musculoskeletal: Arthralgia, myalgia, joint stiffness, muscle aches. Miscellaneous: Periorbital edema, edema, hepatosplenomegaly, burning soles/palms, foot sole pain, proteinuria, anaphylaxis.
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Overdose Management:
No Available information
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Drug Interactions:
Previously masked reactions to Atgam may appear when the drug is given concomitantly with corticosteroids or other immunosuppressants.
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•IV Only Renal allograft recipients.

Adults: 10-20 mg/kg daily. Children: 5-25 mg/kg daily. Usually used concomitantly with azathioprine and corticosteroids. When used to delay the onset of allograft rejection, a fixed dose of 15 mg/kg for 14 days is used; then, the dose is given every other day for 14 days for a total of 21 doses in 28 days. Give the first dose within 24 hr before or after the transplant. When used to treat rejection, the recommended dose is 10-15 mg/kg daily for 14 days; additional alternate day therapy can be given for a total of 21 doses. The first dose can be delayed until after the diagnosis of the first rejection episode.

Aplastic anemia.

10-20 mg/kg daily for 8-14 days; additional alternate day therapy may be given for a total of 21 doses.
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