Description
Gangrene antigangrene serum Pharmacodynamics
The preparation is a protein fraction of horse blood serum hyperimmunized with anatoxins or toxins of gas gangrene pathogens (Clostridium perfringens type A, Cl.oedematiens type A, Cl. septicum), purified and concentrated by peptic digestion and salt fractionation, containing specific toxin neutralizing antibodies.
Biological properties
Antibodies contained in the preparation neutralize toxins of anaerobic microbes Cl.perfringens type A, Cl.oedematiens type A, Cl.septicum.
Indications
Treatment and prevention of gas gangrene.
Contraindications
Contraindications for the use of antigangrene serum are absent.
Pregnancy and lactation:
Use of the drug is allowed on vital indications taking into account possible benefit for mother and risk for fetus or child.
Dosage and administration method
- For preventive purposes, the serum should be injected intramuscularly as soon as possible after injury.
- For therapeutic purposes, the serum is given intravenously, very slowly by drop feeding, usually mixed with 0.9% sodium chloride solution for injection heated to body temperature at the rate of 100-400 ml per 100 ml of serum.
- The serum is heated to (36±0.5) °c and injected: at first 1 ml for 5 minutes and then 1 ml per minute.
- The serum is injected necessarily by a doctor or under his supervision.
- The amount given depends on the clinical condition of the patient.
- Usually the therapeutic dose of antigangrene serum is 150,000 ME:
- – antiperfringence – 50000 ME,
- – antiedematous – 50,000 ME,
- – antisepticum – 50,000 ME.
- Before administering the antigangrene serum, a mandatory intradermal test with purified horse serum diluted 1:100 (ampoule marked red) is performed to check the patient’s sensitivity to proteins of horse serum.
- Purified horse serum diluted 1:100 is injected in a volume of 0.1 ml intradermally into the flexural surface of the forearm (use syringes with a division value of 0.1 ml and thin needles).
- The reaction is recorded after 20 minutes. The test is considered negative if the diameter of edema and (or) redness appearing at the injection site is less than 1 cm. The test is considered positive if the swelling and (or) redness reach a diameter of 1 cm or more.
- If the intradermal test is negative, the anti-gangrene serum (the ampoule is marked blue) is injected subcutaneously in an amount of 0.1 ml. If there is no reaction after 30 minutes, the entire prescribed dose of serum is administered intramuscularly (for prophylactic purposes) or intravenously (for therapeutic purposes).
- In case of a positive intradermal sample, the serum is administered only for unconditional indications, under medical supervision and with special precautions. First, the anti-gangrene serum diluted in doses of 0.5 ml, 2.0 ml, 5.0 ml is injected under the skin (diluted serum is prepared immediately before use by introducing 0.1 ml of anti-gangrene serum in 9.9 ml of 0.9% sodium chloride solution for injection) at intervals of 20 minutes. If there is no reaction to these doses, 0.1 ml of anti-gangrene serum is administered subcutaneously. If there is no reaction after 30 minutes, the entire prescribed amount of the serum shall be injected intramuscularly (for prophylactic purposes) or intravenously (for therapeutic purposes). In case of positive reaction to one of the above-mentioned doses, the anti-gangrene serum is not administered or is administered under anesthesia, having a syringe with 0.1% solution of adrenaline hydrochloride or 0.2% solution of noradrenaline hydratrate ready.
- All manipulations shall be performed with separate sterile syringes. Opened ampoule with anti-gangrene serum shall be closed with a sterile napkin and stored at (20+2) ° C for not more than 1 hour. Opened ampoule with purified horse serum diluted 1:100 must not be stored.
