Anti-botulinum serum (type A, B, E) belongs to the category of immunological medications. The medicine is made in the form of injectable solutions, which have the form of a transparent or slightly opalescent, colorless or yellowish liquid, odorless.
Release form
The drug is produced in ampoules complete with purified horse serum diluted 1: 100, five ampoules in a cardboard box.
The anti-botulinum serum contains specific immunoglobulins and protein fractions of horse serum that were hyperimmunized with botulinum toxins A, B, E. The medicine contains antitoxins that neutralize a specific type of botulinum toxins.
Pharmacological properties
Antibotulinic serum is a protein fraction of horse blood serum immunized with type E, B, A toxin or botulinum toxoid that contains specific immunoglobulins. The composition of this medication contains antitoxins that help neutralize botulinum toxins.
Indications and contraindications
The medication is intended for the treatment and prevention of botulism. Anti-botulinum serum is contraindicated if there is a history of systemic allergic conditions and complications from the previous use of serum, a combination of monovalent sera (types B, A and E), or monovalent serum. In addition, you can not use the drug with hypersensitivity. Also a contraindication to the use of anti-botulinum serum in patients with botulism is the occurrence of anaphylactic shock in determining high sensitivity to horse protein.
Dosage
Antitoxic anti-botulinum serum is used for therapeutic and prophylactic purposes. For therapeutic purposes, it must be administered as early as possible from the moment of the onset of the initial signs of botulism. Prior to the administration of serum, 10 ml of blood should be taken from the patient, as well as urine and vomit for examination to identify the causative agent of botulism and botulinum toxin. It is recommended that you send a food product to the study that provoked the development of the disease.
In the treatment of pathologies caused by an unknown type of botulism toxin, a mixture of monovalent sera (types A, B and E) is used. With a known type of toxin, monovalent serum of the appropriate type is used. Regardless of the severity of the clinical symptoms, one therapeutic dose of the drug is administered dropwise, which must first be diluted in 200 ml of 0.9% sodium chloride solution for injection, heated to a temperature of 37 ± 1 ° C before administration. The infusion rate is 60-90 drops per minute. In special cases, when it is not possible to carry out the drip, it is allowed to administer a dose of serum using a syringe without preliminary dilution. To avoid the development of allergic reactions before intravenous infusion of serum, 60-90 mg of prednisolone is administered to the patient jet. Serum is administered once.
In order to prevent
For prophylactic purposes, this drug is administered to people at the same time as a sick person who consumed products that provoked the development of botulism. In this case, it is necessary to introduce half of the therapeutic dose (half of the ampoule) of the appropriate type of serum. If the type of toxin is not determined, half the dose of all types of monovalent sera is administered. The medicine should be administered intramuscularly.
Before use, the ampoule with the drug is carefully examined. The medicine is not suitable for use in ampoules with a lack of labeling, impaired integrity, with a change in physical qualities (presence of flakes, discoloration), with improper storage or expired shelf life.
Opening of ampoules, storage (no more than an hour) and the procedure for administering the medication are carried out in strict compliance with aseptic and antiseptic standards.
Intradermal test
Before the introduction of anti-botulinum serum to establish sensitivity to another protein, an intradermal test is mandatory, which is included with the drug.
Ampoules with horse serum diluted 1: 100 and purified are marked in red, and with anti-botulinum in black or blue.
Horse serum is administered at a dose of 0.1 ml intradermally in the forearm. A sample is negative if after about 20 minutes the swelling or redness at the injection site is less than 1 cm. The sample is positive if such reactions reach 1 cm or more. In case of a negative test, 0.1 ml of anti-botulinum solution is injected subcutaneously. In the absence of reaction, after half an hour, the entire prescribed dose of serum is administered intramuscularly or intravenously.
In case of a positive test or in cases of allergic reactions to injection, serum is administered only for therapeutic purposes under the supervision of a specialist and subject to special precautions: after intramuscular injection of antihistamines and prednisolone. What else does the instructions for anti-botulinum serum tell us?
Side effects and recommendations for the use of this medication
Its introduction may be accompanied by the occurrence of allergic phenomena of an immediate type, including anaphylactic shock and serum sickness.
Considering the possibility of anaphylactic shock in the patient, medical supervision should be provided for vaccinated people for 30 minutes after the end of the injection or infusion of the drug.
Premises in which the administration of anti-botulinum sera is carried out should have anti-shock therapy (adrenaline).
The introduction of sera (diluted and anti-botulinum) must be recorded in the medical history with an indication of the dosage, time and method of administration, patient response, serial number, name of the manufacturer.
During pregnancy and lactation, the use of this medication is allowed solely for health reasons, taking into account the possible benefits for the mother and the risks to the fetus.
There is no anti-botulinum serum in the free sale, its use at home is strictly prohibited. The medicine is delivered only to medical treatment facilities.
Information on the effect of this medication on the patient’s ability to drive vehicles or other complex and dangerous mechanisms is not presented.
Storage
Freezing of anti-botulinum sera is prohibited. It is necessary to store such medicines at a temperature of 2-8 ° C, for a maximum of 2 years. After this period of time, the drug should be disposed of. An opened ampoule with medicinal serum is allowed to be stored in a cool place for an hour. If the medication has not been used during this time, it should be disposed of.
The anti-botulinum serum administration algorithm must be strictly adhered to.