Antirabies immunoglobulin: manufacturer's instructions

Humanity lives on the planet in the neighborhood with many forms of life, including microscopic ones. First of all, they are viruses and bacteria. Paradoxically, such insignificantly small organisms have a huge impact on the population of people.

Briefly about rabies

During the existence of the human species, many things changed: climatic conditions, landscape, social formations, achievements in science, technology and medicine. It is thanks to the latter that people no longer die from the pandemic pandemics that raged only a few centuries ago. But there were a number of diseases, persistently not amenable to cure, despite all the efforts made. Among them, rabies is particularly prominent.

This ailment is known for a long time. He changed many names, but the terrible essence of the disease remained unchanged - it is deadly dangerous. It is caused by a rabies virus (rabies), which is carried by infected animals. The saliva that got into the wound with a bite is filled with a viral component, and if you do not immediately go to a trauma clinic, the disease will very soon go into an active stage.

The name of the ailment has the word "devil" in the composition - it was the possessed who considered the sick person in antiquity. Symptoms of the disease come on the tenth day. Sometimes the incubation period lasts up to several months and in very rare cases is calculated in years. The essence of the disease is as follows: the virus affects the spinal cord and brain, causing light and hydrophobia, aerophobia, hallucinations, paralysis and other serious disorders. In other words, a person is not able to drink a drink of water, at the sight of which the patient immediately starts cramping, and with the slightest movement of air, the patient experiences sharp muscle spasms. Death occurs due to paralysis of the respiratory muscles and heart muscle.

Two ways to protect

Because the disease is extremely dangerous and almost 100% lethal, people have tried to find ways to treat it or even prevent it for centuries. In the late nineteenth century, the famous microbiologist Louis Pasteur, through many laboratory experiments on animals, invented a vaccine that helped stop the deadly journey of rabies on the planet.

Over time, scientists have found another way to help prevent the disease until the first symptoms appear. This is an antirabic immunoglobulin. At the moment, these drugs are the only barrier to rabies. It should be noted that the rabies vaccine is not capable of destroying the virus, as well as the second drug. Their principle of operation is based on other mechanisms.

Distinctive signs of preparations against rabies

So, what are the principal differences between these medicines?

The action of the vaccine against rabies is based on the following scheme. After the introduction of the drug, the organism receives viral antigens. This is a kind of neutralized analogue of a living virus, containing all the necessary information about it. It is required that the immunity for a certain time (about 2 weeks) develops ways to adequately protect the body. This occurs by the formation of specific proteins - antibodies. These substances remember everything that concerns the antigens of the virus, and if an aggressive agent enters the body, they immediately destroy it. Most vaccines work on this principle. Accordingly, active immunity is produced. For this, an antirabic vaccine is used.

The antirabic immunoglobulin acts somewhat differently. With its help, the organism receives not dead viral antigens, but donor antibodies. The fact is that, while active immunity is being developed, the body is absolutely helpless before the intrusion of harmful microbes. Therefore, the patient is injected with an antirabic immunoglobulin - a drug based on human or animal blood (most often horses). Thus, the body gets a large number of antibodies and antigens (their medication also contains), which help to develop passive immunity. Basically, the drug is used as part of a combined immunization schedule.

The difference between the described medicines is that the vaccine gives a more stable and long-lasting immunity, but after a while, and with the help of immunoglobulin, an immediate but short-term protection of the body from the virus is developed.

Anti-Rabies immunoglobulin: Species

Depending on the origin of antibodies, the drug is divided into two types:

• Heterological.
• Homological.

The first type is called "Immunoglobulin anti-rabies from the horse's serum ". The second one is a medicine based on human blood. It should be noted that to increase the amount of antibodies in the biological material, blood is taken from a person previously vaccinated with an antirabic vaccine. This type of drug is considered more effective and safe than the means of animal origin. The dosage of the homologous species required for immunization is half that.

Four names of such a drug as anti-rabies immunoglobulin are registered. The manufacturer has more than one drug: two medicines are manufactured in Russia (Biopharma, FGBU VNIIZH), the rest in China (FC Sichuan Yuanda Shuyan), Israel (Kamada Ltd.) and Ukraine (Biolak "). Considering the special danger of the disease and the specifics of using such drugs, their implementation is carried out directly - from pharmacies to medical institutions.

"Rebinolin" - anti-rabies immunoglobulin

The first kind of this medication is based on human biomaterial. It is positioned by scientists as more effective. When considering its properties and nuances of application, you should pay attention to the following points:

• Dosage form. Anti-rabies immunoglobulin (the instruction clearly indicates this fact) is a clear or slightly yellowish substance containing a slight precipitate. This drug has the form of a solution for administration into the body intramuscularly or subcutaneously.
• Effects on the body. At least three days after the administration, a maximum antibody concentration aimed at destroying the rabies virus is achieved. These proteins are excreted from the body for a month.
• Indication. Appointed by contact with infected animals, suggesting bites and getting saliva on the affected skin. The preparation is administered in combination with an anti-rabies vaccine for mutual enhancement of the effect.
• Undesirable manifestations. Since a foreign agent enters the body, the reaction can be very acute. In addition to redness, swelling and hyperthermia (sometimes only subfebrile condition is observed), cases of sudden reactions were recorded: Quincke's edema, hives or anaphylactic shock. Short-term vomiting and hypotension were also noted.
• Interaction with other medicines. Incompatible with vaccines containing live viral cultures. It is allowed to use together with antibiotics and antitetanus serum.
• Special instructions. In pregnancy and lactation, the drug can be used, since a long study of the effect of immunoglobulins on the human body allows us to state that the medication will not have a harmful effect on the fetus and the expectant mother.

Immunoglobulin anti-rabies from human blood serum is an effective remedy for preventing rabies. It should be emphasized that there is no contraindication for this drug, since it is prescribed from the point of view of vital criteria. And the earlier the victim applies for help, the more stable the result will be.

Method of application

Before applying an anti-rabies immunoglobulin, the instructions for use suggest the following algorithm:

• Thorough washing of wounds with running water, soap and antiseptic.
• Before the introduction of the drug, check the integrity of the ampoule, the appearance of the medication and the expiration date.
• Anti-rabies immunoglobulin (homologous) is administered taking into account this dosage: 20 IU per kilogram of human body weight.
• It is better if almost the entire dose is injected directly into the wound or nearby affected tissue. If this action is not possible in full, an intramuscular injection is made.
• For children, the drug is injected into the thigh area, the adults into the buttock.

A remedy called "Rebinolin" of Israeli origin. Shelf life of the drug, subject to compliance with the storage regime - 2 years. Freezing immunoglobulin is strictly prohibited. The permissible storage temperature is from 2 to 8 ° C.

A complex approach

Typically, any type of immunoglobulin is administered together with an anti-rabies vaccine. In this regard, there are several points to which it is necessary to pay attention:

• The introduction of rabies immunoglobulin is carried out strictly before the use of the vaccine (break between the drugs - 30 minutes).
• To use the funds are selected different parts of the body, which are as far apart as possible from each other. For example, immunoglobulin - in the left buttock, and the vaccine - in the deltoid muscle on the right.
• Syringes for drugs should be different.
• Intravenous medication is not administered.
• To increase the dosage of anti-rabies immunoglobulin is strictly not recommended.

Preparation based on animal biomaterial

"Immunoglobulin anti-rabies from horse blood serum" (liquid) is classified as a heterologous form. It is considered a little less safe for the reason that the specific proteins that it contains can cause an unpredictable reaction of the body. At the same time, the use of the drug, based on human biomaterial, is relatively calmly tolerated by patients. In this regard, before the use of heterologous immunoglobulin, an intradermal test in the forearm region is mandatory. If after 20 minutes there was no serious edema or redness, then introduce diluted immunoglobulin (a solution of 1 to 100) subcutaneously. And only if after half an hour the sample is still negative, use the rest of the drug. And not immediately, but according to the following scheme: part of the heated dose of rabies immunoglobulin is injected into the wound area, after 15 minutes the next dose is injected into tissues around the wound. If the anatomical features of the bite site do not allow the entire ampoule to be used in the affected area, the rest is used for intramuscular injection. The whole procedure lasts about an hour.

In case if heterologous rabies immunoglobulin is used for immunization, the instruction says that if there is a positive test, antihistamines are prescribed before administration of the drug, and adrenaline solution is used to avoid shock.

Another difference of this species from the previous one is the dosage. An agent based on the horse's serum is used in a twice-increased dose (40 IU per kilogram of body weight).

Vaccine against rabies

At the moment on the territory of the Russian Federation there are registered 5 preparations of domestic production and one - Indian. This vaccine is produced in clear ampoules complete with distilled water and contains inactivated rabies virus. After breeding, it looks like a pink or colorless liquid. When using this tool, there are important nuances:

• When the introduction is mandatory, the necessary rules of antiseptic are observed, and the vaccination room must be equipped with anti-shocks and preparations for emergency treatment. After breeding it is allowed to store the rabies vaccine for no more than 5 minutes.
• Half an hour after the homologous immunoglobulin was introduced, the use of the vaccine is permitted.
• The drug is injected into the thigh (children under 5 years) or in the deltoid muscle of the shoulder girdle. The use of the drug in the buttock area is strictly prohibited.
• The patient should be under supervision of the medical staff for at least half an hour after the manipulation.

Types of immunization

There are two types of immunization: preventive and curative and preventive. The first is used in case a person is engaged in potentially dangerous activity, where the risk of getting infected with rabies is high. These are hunters, yegeri, workers of bacteriological laboratories, veterinarians. The second type is applied immediately after contact with a sick animal. Both versions have a certain execution algorithm. In addition to schemes, there is one more difference between these types. If in the first case a contagious disease can become a chronic disease in the acute stage or pregnancy, the second type of immunization is carried out according to vital indications.

Vaccination schedules

The usual vaccination scheme is as follows:

1. If the nature of the contact involves minor damage to the skin - scratches, small bites, abrasions, as well as mothballing by domestic animals, all of which are in the trunk and limb region, then the person is vaccinated immediately after treatment of the lesions. A single dose of rabies vaccine is 1 ml. Immunization is carried out on the day of contact, and further, on the 3rd, 7th, 14th, 30th and 90th day. The scheme can be changed if the animal under surveillance has not died or has not been identified as a rabies virus. In this case, limited to a triple introduction of the vaccine.
2. Any wounds of the head, neck, hands, genitals, ankles and fingers caused by domestic animals, as well as damages or moulting from wild animals, rodents and bats, require immediate comprehensive measures. On the day of the contact, before the introduction of rabies vaccine, a mandatory injection of immunoglobulin, carried out according to the above rules, is applied. Immunization is then carried out according to the standard scheme.

According to vital indications

This phrase often sounds in the doctors' offices or on the territory of the hospital wards, so everyone is used to it. But unfortunately, people sometimes tend to forget how valuable human life is. Every day to see the smile of his child, to hear the voice of his mother in the tube, to observe the flight of birds - all this is so ordinary that it is taken for granted. And only when the house is knocking trouble, people remember this. Take care of yourself and your loved ones, and in case of potential danger do not delay seeking help.