Template:Crofab dosing: Difference between revisions
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===Initial Administration=== | ===Initial Administration=== | ||
*Initial dose: 4-6 vials | |||
* | **May repeat dose in 2 hours if symptoms not controlled | ||
*Typically diluted into 250 cc or 1 L of normal saline and infused over an hour. | |||
*Same dose for both adults and pediatrics (may have to adjust the dilution of CroFab for small children so that they are not volume overloaded) | |||
===Maintenance therapy=== | ===Maintenance therapy=== | ||
*Infuse 2-vial doses at 6, 12, and 18hr after initial control achieved | |||
*''Maintance therapy may be indicated after initial dosing based on local protocols even if control is achieved.<ref>Crofab treatment agorithmn http://www.crofab.com/documents/CroFab-Treatment_Algorithm.pdf</ref> | *''Maintance therapy may be indicated after initial dosing based on local protocols even if control is achieved.<ref>Crofab treatment agorithmn http://www.crofab.com/documents/CroFab-Treatment_Algorithm.pdf</ref> | ||
===Envenomation control measurement=== | ===Envenomation control measurement=== | ||
* | *Observe for progression of envenomation during and after antivenom infusion | ||
*Measure limb circumference at several | *Measure limb circumference at several sites above and below bite | ||
*Mark advancing border of edema q30min | *Mark advancing border of edema q30min | ||
*Repeat labs q4hr or after each course of antivenom (whichever is more frequent) | *Repeat labs q4hr or after each course of antivenom (whichever is more frequent) | ||
=== | |||
===Side Effects=== | |||
*Acute allergic reactions occur in <10% pts | *Acute allergic reactions occur in <10% pts | ||
**If occurs stop infusion and give epinephrine/antihistamines if needed | **If occurs stop infusion and give epinephrine/antihistamines if needed | ||
Revision as of 04:31, 6 July 2017
Initial Administration
- Initial dose: 4-6 vials
- May repeat dose in 2 hours if symptoms not controlled
- Typically diluted into 250 cc or 1 L of normal saline and infused over an hour.
- Same dose for both adults and pediatrics (may have to adjust the dilution of CroFab for small children so that they are not volume overloaded)
Maintenance therapy
- Infuse 2-vial doses at 6, 12, and 18hr after initial control achieved
- Maintance therapy may be indicated after initial dosing based on local protocols even if control is achieved.[1]
Envenomation control measurement
- Observe for progression of envenomation during and after antivenom infusion
- Measure limb circumference at several sites above and below bite
- Mark advancing border of edema q30min
- Repeat labs q4hr or after each course of antivenom (whichever is more frequent)
Side Effects
- Acute allergic reactions occur in <10% pts
- If occurs stop infusion and give epinephrine/antihistamines if needed
- Recurrent thrombocytopenia has been described up to 2 weeks after transfusion with FabAV and is likely a result of isolated renal clearance of FabAV and persistent presence of actual venom in serum.[2]
- Warrants close monitoring of platelets by primary physician or return visit after discharge
- Serum sickness is unlikely but precautions should be given to patents upon discharge
- ↑ Crofab treatment agorithmn http://www.crofab.com/documents/CroFab-Treatment_Algorithm.pdf
- ↑ Ruha AM et al. Late hematologic toxicity following treatment of rattlesnake envenomation with crotalidae polyvalent immune Fab antivenom. Toxicon. 2011;57:53–59.