Rh immunoglobulin

Anti-Rhesus immunoglobulin is a protein substance used in various fields of medicine. Its main application is related to the prevention of Rhesus conflict (use in gynecology and obstetrics, transplantology, hematology and tissue transplantation). As statistics show, the main percentage of the drug's use falls on gynecology.

Anti-Rhesus Immunoglobulin: Pros and Cons

The active substance has an immunostimulating effect, counteracts the Rh factor. It is a biologically active component of natural origin. There are numerous disputes regarding the appointment of anti-Rhesus immunoglobulin. Some are in favor of its use, others are against it. But in any case, there is a lot of information indicating its effectiveness.

It is convincingly confirmed that the main action of the drug is aimed at stabilizing biochemical processes and preventing the agglutination reaction between blood groups with different Rh factors. As is known, the Rh factor is a protein that is present in the blood of Rh-positive people and is absent in the blood of Rh-negative people. If a person with a negative Rh factor is given blood with a positive Rh factor during a transfusion, an agglutination reaction occurs, during which the red blood cells stick together, are destroyed, which leads to complete blood clotting, the formation of blood clots with subsequent death of the person. A similar picture is observed during organ transplantation.

Prevents rejection of transplanted tissues, miscarriages, spontaneous abortions, significantly increases the number of stillbirths, miscarriages, maternal mortality, postpartum complications. Differences in the Rh factor between a woman and a man can cause the inability to conceive.

Since anti-Rhesus immunoglobulin prevents the cell agglutination reaction and acts as a means of preventing isoimmunization, it is hardly possible to oppose its use in the course of treatment. However. The prescription of this drug can only be advocated after a thorough examination, since its incorrect use can also entail serious consequences, including death. Therefore, it is extremely important to know the blood group of the person who will receive treatment. This information is rechecked several times. [ 1 ]

Indications anti-rhesus immunoglobulin

It is important to remember that the drug is extremely dangerous and requires a serious approach and preliminary research. If this drug is used incorrectly, it can be fatal, so it can be said that in this case there is no room for error. The drug should be prescribed strictly by a specialist, and there must be good reasons for this. [ 2 ]

Rhesus conflict in any of its manifestations is a direct basis for the appointment of anti-Rhesus immunoglobulin. An indication for use is a situation in which the mother is Rh-negative and has sensitization to the Rh factor of the child, who in turn is Rh-positive. In this case, any situation associated with the entry of the child's blood into the mother's body requires immediate administration of immunoglobulin. This is usually done within three days after actual or probable contact. This is done after childbirth, or for prophylactic purposes several days before childbirth, as well as before or after any manipulations when the fetus's blood may come into contact with the mother's blood, for example, when taking a biopsy, during miscarriages and abortions, during amniocentesis and other similar procedures, as well as in case of injuries. This also includes cases of transplantation of biological material, blood transfusion and red blood cell mass. [ 3 ]

Release form

The medicine is liquid, transparent and colorless. Dark liquid is a sign of contamination. When held up to daylight, the liquid may be opalescent and have a slight sheen on the surface of the liquid. Basically, an ampoule contains 1 ml of liquid, which is enough for 1 dose. They are packed in a cardboard box (10 ampoules per box). An ampoule knife is also placed in the box. Shake the ampoule before use, as the solution tends to form a sediment.

The drug is produced under various commercial names, however, the only possible active substance is human immunoglobulin, tropic in relation to rhesus receptors. In the pharmaceutical industry, the following are available for sale: camrow, hyperrow, immunoro kedrion, resonativ, and actually anti-rhesus Ig. The pharmacological characteristics are the same in all drugs, the active substance is the same.

• Camroe

Produced in Israel. Similar to pure domestic. One ampoule contains a single dosage.

• Hyperrow

The composition includes human immunoglobulin. It should be taken into account that immunoglobulin does not penetrate the transplacental barrier, therefore, accordingly, it does not cause harm to the fetus. It reduces sensitization and destroys the Rh factor only in the mother's blood, but not in the child's blood.

• Immunoro kedrion

Powder intended for the preparation of suspension. Immunoro kedrion is produced in Italy.

• Resonative

Resonativ is produced in Sweden and is available in ampoules with a dosage of 150 mcg and 300 mcg.

• Anti-Rhesus immunoglobulin D

It disrupts the basic biochemical properties and activity level of the Rh factor, and also reduces the susceptibility (sensitization) of the body to this factor. Immunoglobulin contributes to the fact that the sensitivity of the body to this substance is sharply reduced, respectively, antibodies are not produced. Anti-Rhesus immunoglobulin D is produced by domestic manufacturers and is used in many areas of medicine.

Pharmacodynamics

Speaking about pharmacodynamics, it is worth noting that the substance itself belongs to the group of protein components (immunoglobulins), which have a corrective effect on molecular and cellular components and metabolic mechanisms.

In case of violation of individual blood components, it corrects the condition, in case of decrease in the functional state of immunity, it stimulates its activity, in case of tendency to autoimmune aggression against the background of hyperfunction and tension of immunity, it has a normalizing (inhibitory) effect. But the main effect is that the drug prevents rhesus conflict.

Pharmacokinetics

When analyzing the pharmacokinetic features, it is worth noting that it has a high degree of immunological activity.

The drug circulates in the blood for quite a long time, at least 3-4 weeks, thus providing a protective effect.

Dosing and administration

Side effects, harm and damage to the body are rare, mainly due to improper use of the drug, as well as a strong tendency to allergic reactions. For example, some people, especially those who have a tendency to immediate hypersensitivity reactions, may develop Quincke's edema, anaphylactic shock, or an asthma attack. But this happens rarely.

• Timing of administration of anti-Rhesus immunoglobulin

The recommended period is the first three days after the Rh factor enters the blood. In fact, the sooner the drug is administered, the easier it will be to prevent the consequences.

• Where is anti-Rhesus immunoglobulin injected?

It is recommended to inject intramuscularly. The doctor determines where exactly to inject. The optimal place is the upper outer quadrant of the gluteal muscle. But they also inject into the front surface of the thigh (femoral muscle), into the shoulder (biceps).

• Antibodies after anti-Rhesus immunoglobulin

In response to this protein component, antibodies are formed. But after the introduction of anti-Rhesus immunoglobulin, they are neutralized, and the body's sensitization is reduced.

• Anti-Rhesus immunoglobulin antibody titers

There are 2 known types of anti-Rhesus immunoglobulin antibody titers: 1500 and 3000 U of the substance, which corresponds to a dosage of 150 mcg and 300 mcg. This is a single dosage intended for one administration. The maximum amount of the drug appears in the blood after 24 hours, it continues to circulate in the blood for 4-5 weeks, protecting the body from destructive effects.

Application for children

Treatment of hemolytic disease in children requires the use of immunospecific immunoglobulin (immunoglobulin group G). A distinctive feature of this drug is that its main mechanism of action is aimed at stimulating the function of hematopoiesis, general stimulation of the immune system, reducing the body's sensitization, providing antiviral, antibacterial, antitoxic protection. It should be noted that, depending on the needs of the child's body, various agents can be used: antistaphylococcal, antiherpes, anticytomegalovirus.

Use anti-rhesus immunoglobulin during pregnancy

If antibodies to the Rh factor are formed in the body of a pregnant woman, they are first aimed at neutralizing the Rh factor that has entered the woman's bloodstream, and then at the fetus itself as a source synthesizing substances dangerous to the woman's life. In the absence of treatment, various complications usually develop in the mother and child, up to and including death.

• Anti-Rhesus immunoglobulin after birth

It is prescribed for several days after birth, and injections are given for at least three days in a row. This helps the mother's body to receive a substance that reduces its activity against the components of the child's red blood cells. Accordingly, the Rh conflict is prevented.

• Anti-Rhesus immunoglobulin after abortion, miscarriage

The time of administration should be minimal. As soon as even the slightest probability of a negative outcome appears, injections are given immediately. It is recommended for various events involving the introduction of the Rh factor into the body (during transplantation, infusion of red blood cell mass).

Contraindications

It is prohibited to inject the drug into newborns. It is prohibited to use it in women who have given birth and those who have given birth who are sensitized to the Rh factor, that is, have antibodies to it in their blood.

Side effects anti-rhesus immunoglobulin

The drug is harmful to Rh positive individuals. Side effects are associated with the destruction of the Rh factor and the inactivation of antibodies to it. Of course, this is dangerous for those people who are positive according to this indicator. It is worth noting that it brings undoubted benefits to people with a negative status. Headache, mild nausea, dyspeptic disorders, impaired coordination of movements, mild headache are not excluded.

Overdose

Overdose has not been described in practice. But theoretical sources indicate that exceeding the dose may lead to excessive stimulation of the immune system and cause autoimmune aggression.

Interactions with other drugs

Does not enter into reactions (natural substance, protein origin).

Anti-Rhesus Immunoglobulin and Alcohol

Usually, in the body of a sensitized person, it does not interact and does not enter into chemical reactions. Theoretically, this allows us to assume that it can be combined with alcohol. But as practice shows, it is better not to do this.

The fact is that immunoglobulin is an antibody, and all antibodies are known to be enzymes. They are synthesized in the body, and any substance can have both an inhibitory and a stimulating effect on them. Alcohol is no exception. Alcohol stimulates the enzyme alcohol dehydrogenase in the body, which breaks down alcohol and its decay products. Thus, alcohol has the ability to stimulate enzymatic activity. As a result of the cross-reaction between immunoglobulin and alcohol dehydrogenase, as well as other enzymes, a reaction can occur. Excessive activity, as well as slow activity, can negatively affect health, enzymatic activity, composition and properties of blood. It is worth noting that this can disrupt all biochemical processes in general, and also entail a violation of the hormonal background and immune status. This state of affairs not only does not contribute to the normalization of the condition, but also aggravates the pathology.

Storage conditions

The drug should be stored in strict compliance with storage conditions. It is recommended to store in the refrigerator, at a temperature of no more than 10-12 degrees and no lower than 2 degrees. Transport at a similar temperature. Store in the original packaging. Immediately before the injection, take it out of the refrigerator and hold it for 1.5-2 hours at room temperature so that the drug warms up a little. Do not leave it in direct sunlight or near central heating batteries or heaters.

Shelf life

As for the unopened drug, its shelf life is 2-3 years. An opened bottle cannot be stored, it is immediately disposed of (one ampoule is designed for one injection, which is administered once).

Analogues

All medicinal preparations, the active ingredients of which are anti-Rhesus immunoglobulin D of a person, can be considered as analogues. This can be a domestic preparation with a similar name. Foreign analogues are also used, such as: hyperrow, camrow, immunoro kedrion, resonativ, and other preparations.

Reviews

If you analyze the reviews, you can see that positive ones prevail among them. Negative reviews were encountered only 2 times and were related to incorrect use of the drug and its individual intolerance. In the first case, an allergy in the form of urticaria developed and the local temperature at the site of the bite increased (the drug was incorrectly administered, or the suspension was incorrectly prepared).

In the second case, intolerance to the drug immunoro kedrion developed. The girl complained of headache, dizziness, nausea, vomiting, bloating. Perhaps this was due to the fact that it contains other components, in particular auxiliary substances. In this case, the drug was replaced with pure, domestic anti-Rhesus immunoglobulin, and the condition returned to normal. Otherwise, the reviews were positive: the drug effectively eliminated and prevented Rh-conflict. A characteristic feature is that the drug acts quickly and requires a single administration. It remains in the blood for up to 5 weeks, providing reliable protection for the body.