|
Reconstitution of Lyophilised Serum:
The lyophilized Tetanus antitoxin is supplied in freeze dried form in glass vial along with 1 ml of sterile water of injection I.P. Draw 1 ml of Sterile Water for injection in a sterile syringe and transfer to lyophilized serum vial and shake gently till the content dissolve. The reconstituted serum is clear and colourless to pale yellow and ready for injection.
Administration:
Tetanus antitoxin is given prophylactic ally to persons at the risk of tetanus infection by infected wounds or severe wounds. A dose of 1500 IU should be given intramuscularly or subcutaneously and the dose may doubled or trebled in case multiple and severe wounds. Prophylactic dose is also given in surgical operations as post operative care.
Along with this passive immunization it is advisable to initiate active immunization with adsorbed Tetanus toxoid.
Indications:
Tetanus antitoxin neutralizes the toxin produced by Clostridium tetani; the toxin has high affinity for new cells and antitoxin is unlikely to have an effect on toxin that is no longer circulating. Tetanus antitoxins have been used to provide temporary passive immunity against tetanus but tetanus immunoglobulins are preferred (Reynolds, 1990; McEvoy et al. 1988). Human globulin offers the advantage of greater protection, a lower risk of adverse effects and requires only one-tenth of the dosage compared to antitoxin of animal.
Contraindiactions:
Sensitivity testing (e.g., skin test, conjunctival test) should be conducted in all individuals, regardless of clinical history, prior to administration of tetanus antitoxin.
In case of patients receiving tetanus antitoxin serum, it should be essential to test for hypersensitivity of the individual with a test dose.
Serum sensitivity test is carried out by injecting 0.1 ml serum in 1:10 dilution either subcutaneously or intracutaneously and observing for half an hour for any reactions of local or general. In case of hypersensitive reaction, serum should be given with great caution in small divided dose subcutaneously at regular intervals of half an hour. Injection adrenaline (1:1000) must be at hand for immediate treatment of shock, if it develops. Intravenous administration of serum is not recommended in hypersensitive cases.
In some cases symptoms as itching, urticarial rash, pains in joints and muscles, fever, enlargement of lymph glands, appear about 7-12 days after injection of serum. These should be treated with antihistamines and corticosteroids. Usually these symptoms of serum sickness last a few days and patients recover without any complication.
Storage:
The liquid Tetanus antitoxin should be stored between 20C to 80C. It should not be allowed to freeze. Freeze dried Tetanus antitoxin can be stored in a cool, dark place or in a refrigerator, if available. Reconstituted liquid should not be stored for a long time and should not be allowed to freeze.
Presentation:
Tetanus antitoxin is supplied as 1 ml liquid in glass vial/ ampoule and also supplied as freeze dried powder with 1 ml of Water for Injection I.P. for reconstitution.
Disposable:
Left over antiserum and used vials should be discarded as biomedical waste.
|
