Antitetanus serum. Horse tetanus serum (purified concentrated liquid) - instructions for use, analogs, indications, contraindications, action, side effects, dosage, composition

Tetanus is a dangerous infectious disease that can enter the body through damaged skin. In case of accidental injury and suspected infection, you should contact a medical facility as soon as possible to examine the injury and administer anti-tetanus serum.

Description

The causative agent of the infection is tetanus bacillus or a gram-positive flagellated bacterium that lives and multiplies in an oxygen-free environment. The bacterium itself does not pose a great danger to humans, but the exotoxin it produces can be fatal.

When ingested, it penetrates the spinal cord and medulla oblongata through the motor fibers of the peripheral nerves. The activity of the rod is manifested by severe convulsions of the upper and lower extremities, as well as difficulty breathing.

The action of anti-tetanus serum is aimed at neutralizing the toxic toxin. It consists of immunoglobulins from the blood of a horse that has previously been vaccinated with tetanus toxin and toxoid. The whey goes through several stages of purification and is concentrated using salt fractionation.

Important! Externally, the serum is a clear or yellowish liquid without sediment, produced in glass ampoules.

Indications and contraindications

The drug is intended to get rid of infection and is used in emergency situations. It is also used as a vaccine to prevent tetanus infection. The main reasons for emergency serum administration are:

• bites from animals that have not been vaccinated;
• penetrating wounds of the skin;
• damage to the gastrointestinal tract;
• abscesses, necrosis and gangrene;
• frostbite;
• births and abortions that took place outside medical institutions;
• burns of varying severity;
• violation of the integrity of the mucous membranes.

But not all of the above cases require the introduction of serum. It is not administered in the following cases:

• children and adults who have a document confirming a routine tetanus vaccination;
• patients who have undergone a full course of body immunization (no later than 5 years ago).

There are also contraindications for administering antitoxin:

• elevated body temperature at the time of hospitalization;
• individual intolerance to the drug;
• first half of pregnancy in women.

Introduction dates

At the first suspicion of tetanus infection, you should go to the hospital as soon as possible. The incubation period of the infection is 7-10 days, but sometimes a latent form of tetanus occurs, which may not manifest itself for 1.5-2 months.

Important! To prevent irreversible consequences, the serum should be administered within 15-20 days from the moment of suspected infection.

Routine vaccinations against tetanus are carried out in early childhood - at 3, 4, 6, 18 months and 6 years. If prophylaxis is carried out for an adult, then the full course consists of 3 injections of the drug - the break between the first and second dose is 1 month, between the second and third - 1 year. The duration of action of anti-tetanus serum in these cases is 10 years, after which the course should be repeated.

Mode of application

Vaccination is carried out intravenously or directly into the spinal canal. Before administering the full dose, an allergy test is taken from the patient for a foreign protein.

To do this, 0.1 ml of the drug is injected into the forearm area under the skin. A reaction occurs within 20 minutes. If there is no redness or no more than 1 cm in diameter, a full dose of serum can be administered (100,000-200,000 IU).

Important! After emergency vaccination, the patient should be under medical supervision in case the body experiences a shock reaction.

To avoid negative consequences, you should follow the instructions for use.

1. First of all, you should carefully examine the ampoule. Its integrity must not be compromised; factory marking is required. The preparation itself should be transparent or with a slight yellowish tint, without precipitation.
2. Next, you need to thoroughly wash your hands and put on sterile gloves, open the ampoule and draw out the medicine using a long needle with a wide bore.
   

   Important! The substance can be stored for no more than 30 minutes after opening the ampoule.

3. After changing the needle on the syringe, the serum is injected into the skin area treated with 70% alcohol. For emergency therapy, local administration (to the wound site) is allowed.
4. After the procedure, the injection site must be lubricated with iodine and massaged with a special sterile ball so that the serum can be quickly absorbed by the body.

Possible complications

Side effects from tetanus serum are observed in patients who have been found to have an individual intolerance to horse protein. In this case, the following manifestations are possible:

• redness of the skin and itching in the injection area;
• slight malaise, weakness;
• elevated body temperature during the first few hours after vaccination;
• muscle spasms and cramps of the limbs;
• nausea and vomiting.

As a rule, these symptoms disappear on their own within 24 hours after administration of antitetanus serum. But sometimes there are more serious complications that should be addressed immediately by a doctor:

• the occurrence of rhinitis;
• cough, dry mouth;
• joint pain;
• fever;
• inflammation of the lymph nodes.

Such symptoms indicate a serious allergic reaction of the patient to the injected serum and require prompt hospitalization. If the patient does not consult a doctor in time, there is a risk of anaphylactic shock.

Below is a video where you can learn all the details about the tetanus vaccine.

Participation in the administration of antitetanus serum to patients,

Administration of tetanus serum and toxoid

Equipment: a ampoules of AS-anatoxin and PSS, beads with alcohol, syringes and needles, anti-shock therapy: 0.1% adrenaline solution, ice pack, venous tourniquet, desensitizing agents, prednisolone or hydrocortisone

Performing the manipulation:

1. Inform the patient about the upcoming procedure and obtain his consent

2. Before administration, the ampoule with the drug is carefully inspected. The drug should not be used in the following cases:

· If there is no label on the ampoule

· If there is no complete information about the drug on the label

· If there are cracks on the ampoule

If there are unbreakable flakes, sediment or foreign matter

· In case of expired

· In case of improper storage of the drug

3. Wash your hands hygienically

4. Wear sterile gloves

5. Immediately before administration, the ampoule is shaken until a homogeneous suspension is obtained.

6. When opening the ampoule, before and after the incision is made with a file, wipe it with a sterile cotton ball with alcohol. An opened ampoule with AS toxoid or PSS can be stored covered with a sterile napkin for no more than 30 minutes.

7. The drugs are drawn into a syringe from the ampoule using a long needle with a wide bore. Always use a different needle for injection.

8. Before vaccination, 1-2 drops of the contents of the syringe are passed through the needle with which the injection will be performed.

9. When administering AS-anatoxin, the skin at the injection site is disinfected with 70% alcohol, grabbed into a fold with the fingers of the left hand, and the needle is inserted into the base of this fold into the subcutaneous tissue from top to bottom. Anatoxin is injected deep under the skin under the lower angle of the scapula (the indicated area is poor in nerves and contains loose fiber)

10. When carrying out emergency prophylaxis of tetanus as prescribed by a doctor, AC-toxoid can be injected into the region where the wound is located (if its localization allows) by subcutaneous injection

11. After administering the drug, the injection site is lubricated with iodine or alcohol and lightly massaged with a sterile ball.

12. Before PSS administration, an intradermal test with horse serum diluted 1:100 is mandatory to determine sensitivity to horse serum proteins (the ampoule is marked in red)

13. To take the sample, use an individual ampoule, as well as sterile syringes with 0.1 ml graduations and a thin needle

14. Serum diluted 1:100 is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml

15. The reaction is taken into account after 20 minutes. The test is considered negative if the diameter of the swelling or redness at the injection site is less than 1.0 cm. The test is considered positive if the swelling or redness at the injection site reaches a diameter of 1.0 cm or more

16. If the skin test is negative, antitetanus serum (TSS) from an ampoule marked in blue is administered subcutaneously in a volume of 0.1 ml

17. Observe the patient's condition. During this time, the opened ampoule with PSS should be covered with a sterile napkin

18. If there is no reaction, the remaining dose of serum is administered after 30 minutes

19. Each vaccinated person must be provided with medical supervision for an hour after vaccination.

20. The patient should be informed that if severe malaise occurs after vaccination, accompanied by headache, fever or local reaction with swelling and redness or the appearance of symptoms of serum sickness, he should immediately seek medical help

21. For persons with a positive reaction to intradermal injection of 0.1 ml of horse serum diluted 1:100 or who had a reaction to subcutaneous injection of 0.1 ml of PSS, further administration of PSS is contraindicated

Advertisement

23. Monitor the patient’s condition

Completing the manipulation:

1. Information about the patient and the emergency prophylaxis of tetanus administered to him is entered into the register of care for injuries in the section “emergency prophylaxis”, indicating the date, name of the drugs administered (AS, PSS), time of administration, dose, series, manufacturer of the drug, as well as reactions to the administered drug. This data should then be entered into the outpatient card, the log of preventive vaccinations, as well as the logs of emergency prophylaxis of tetanus in case of injuries

2. The used material is processed in accordance with industry regulations on disinfection, pre-sterilization cleaning and sterilization of medical products.

3. Conduct disinfection and disposal of medical waste in accordance with San.PiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions”

Administration of anti-rabies drugs

Equipment: rabies vaccine, rabies gamma globulin, syringes, needles, sterile beads with alcohol, solutions of adrenaline (1:1000) or ephedrine (5%), diphenhydramine (2%) or suprastin (2%)

Preparation for manipulation:

1. Explain to the patient the purpose and meaning of the upcoming manipulation and obtain his consent

2. Warn the patient that in order to create lasting immunity and prevent post-vaccination complications, those vaccinated are prohibited from drinking alcoholic beverages during the entire course of vaccinations

3. Warn the patient so that during the course of vaccinations he does not overwork, avoid hypothermia, overheating, and maintain skin hygiene

4. Vaccinations should not be given to victims on an empty stomach.

Performing the manipulation:

· Administration of anti-rabies gamma globulin

1. Wash your hands hygienically

2. Wear sterile gloves

3. Before administering rabies gamma globulin, the body’s sensitivity to horse serum is checked by intradermal testing. To do this, 0.1 ml of a 1% (1:100) solution of anti-rabies gamma globulin is injected intradermally into the area of ​​the inner surface of the forearm. The reaction is taken into account after 20 - 30 minutes. The test is considered negative if the diameter of the papule is up to 1 cm and the redness around it is limited. The test is considered positive if the diameter of the papule exceeds 1 cm and diffuse redness

4. If the test is negative, 0.7 ml of 1% rabies gamma globulin is injected into the subcutaneous tissue of the shoulder

5. If there is no reaction, after 20-30 minutes, the entire prescribed therapeutic and prophylactic dose of whole anti-rabies gamma globulin, heated to 37 degrees, is administered intramuscularly into the upper outer quadrant of the buttock in 2-3 doses with an interval of 10-15 minutes.

6. The entire dose of anti-rabies gamma globulin is administered in one day

7. 24 hours after the last injection of rabies gamma globulin, a course of rabies vaccine vaccinations begins

8. If there are vital indications and a positive test, or in cases of an anaphylactic reaction to an intradermal injection, anti-rabies gamma globulin is administered with special precautions:

· If there is no response to these doses, 0.1 ml of whole anti-rabies gamma globulin is injected into the subcutaneous tissue of the shoulder

· If there is no reaction, after 30 minutes the entire prescribed dose of anti-rabies gamma globulin (warmed to 37 degrees in the thickness of the gluteal muscles) is administered in 2-3 doses with an interval of 10-15 minutes

· When administering gamma globulin, a solution of adrenaline or ephedrine, diphenhydramine or suprastin should always be ready

· Introduction of rabies vaccine

1. The rabies vaccine is administered to the victim with a thin needle in a lying position, slowly, strictly subcutaneously, retreating from the midline of the abdomen by 2-3 fingers at or below the navel in different areas

2. If it is impossible to inject the vaccine into the subcutaneous tissue of the abdomen, for example, due to scars, large infiltrates, in some cases the vaccine can be injected into the subcutaneous tissue in the area of ​​the shoulder blades

3. After administration of the rabies vaccine, the patient is not recommended to stand up for 5 minutes

Completing the manipulation:

1. The used material is processed in accordance with industry regulations on disinfection, pre-sterilization cleaning and sterilization of medical products.

Transparent or slightly opalescent, colorless or yellowish liquid without sediment. It is a protein fraction of the blood serum of horses immunized with tetanus toxoid or toxin, which contains specific immunoglobulins, purified and concentrated by peptic digestion and salt fractionation.

Contains chloroform in a concentration of no more than 0.1%.

Compound

The ampoule contains one prophylactic dose equal to 3000 international units (IU).

Release form

Available in ampoules. The ampoule contains one prophylactic dose. Available complete with purified horse serum diluted 1:100, which is a clear, colorless liquid without sediment.

Antitetanus serum liquid.

Immunological and biological properties

Neutralizes tetanus toxin.

Indications

Urgent specific prevention and treatment of tetanus.

Directions for use and doses

Treatment of tetanus. Antitetanus serum is administered to patients as soon as possible from the onset of the disease at a dose of 100,000 - 200,000 IU.

The serum is injected intravenously or into the spinal canal after testing sensitivity to foreign proteins. Depending on the severity of the disease, the administration of serum is repeated until the reflex symptoms disappear.

Emergency prevention of tetanus involves primary surgical treatment of the wound and, if necessary, reproduction of specific immunity against tetanus.

Emergency specific prophylaxis of tetanus is carried out when:

• injuries with violation of the integrity of the skin and mucous membranes
• frostbite and second, third and fourth degree burns;
• out-of-hospital abortions;
• childbirth outside medical institutions;
• gangrene or tissue necrosis of any type, abscesses;
• animal bites;
• penetrating injuries of the gastrointestinal tract.

For emergency specific prevention of tetanus, the following is used:

• AS-anatoxin;
• anti-tetanus human immunoglobulin (TSHI)
• in the absence of PSCH - purified concentrated liquid antitetanus serum (PPS).

AS-anatoxin and PSCHI are administered in accordance with the instructions for the use of these drugs.

A scheme for selecting prophylactic agents for emergency specific prophylaxis of tetanus is provided in Appendix No. 1.

Antitetanus serum for the purpose of emergency prevention of tetanus is administered subcutaneously at a dose of 3000 IU.

Side effect

Sometimes the administration of serum is accompanied by various allergic reactions: immediate (immediately after administration of the serum or after a few hours), early (on days 2-6) and late (on the 2nd week and later).

These reactions are manifested by the symptom complex of serum sickness (fever, itching and rashes on the skin, joint pain, etc.) and, in rare cases, anaphylactic shock.

Contraindications

There are no contraindications for the use of antitetanus serum for therapeutic purposes.

Contraindications for the use of specific means of emergency prophylaxis of tetanus:

1. A history of hypersensitivity to the corresponding drug.

2. Pregnancy

• in the first half, the administration of AS-anatoxin and PPS is contraindicated;
• in the second half, the administration of PPS is contraindicated.

Features of application

The drug is unsuitable for use if the integrity of the ampoules is damaged or if there is no labeling, if the expiration date has expired, if the physical properties have changed or if it has been improperly stored.

Before administering anti-tetanus serum, an intradermal test should be performed with purified horse serum diluted 1:100 to test sensitivity to foreign proteins. To take samples, use a syringe with 0.1 ml divisions and a thin needle. The diluted serum is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml. Observe for 20 minutes.

The test is considered negative if the diameter of the swelling or redness that appears at the injection site is less than 1 cm. The test is considered positive if the swelling or redness reaches a diameter of 1 cm or more.

If the intradermal test is negative, anti-tetanus serum is administered subcutaneously in an amount of 0.1 ml (use a sterile syringe, close the open ampoule with a sterile napkin). If there is no reaction, after 30 minutes, using a sterile syringe, the entire prescribed dose of serum is administered subcutaneously (for prophylactic purposes), intravenously or into the spinal canal (for therapeutic purposes).

If the intradermal test is positive or an anaphylactic reaction occurs to a subcutaneous injection of 0.1 ml of anti-tetanus serum, its further administration is contraindicated. In this case, PSCH should be entered.

In 1 ml tetanus antitoxin 3000 IU (prophylactic dose for emergency prophylaxis).

In 1 ml tetanus antitoxin 10,000, 20,000 or 50,000 IU (for the treatment of tetanus).

Release form

Ampoules in a package of 5 pieces (the serum is marked in blue) complete with 5 ampoules of diluted serum, which is used to determine sensitivity.

pharmachologic effect

Neutralizes tetanus toxins.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Antitetanus serum contains immunoglobulins blood serum of horses immunized with tetanus toxin . The whey is purified and concentrated by peptic digestion. Specific antibodies serums neutralize tetanus toxin . The use of antitetanus serum (of varying activity) is indicated for prophylaxis tetanus and in the treatment of disease.

Pharmacokinetics

Data not provided.

Indications for use

Prevention of tetanus:

• injuries in which there is a violation of the integrity of the skin;
• frostbite and high degree burns;
• gangrene , necrosis fabrics, abscesses ;
• out-of-hospital abortions and childbirth outside specialized institutions;
• animal bites;
• penetrating damage Gastrointestinal tract .

Contraindications

• increased sensitivity;
• systemic allergic reactions to previous serum injections;
• first half pregnancy (injection of serum and AC toxoid );
• second half pregnancy (injection of serum).

During lactation, administration is possible for health reasons, taking into account the benefits for the woman and the risk for the child.

Side effects

Antitetanus serum, instructions for use (Method and dosage)

For emergency prevention tetanus antitetanus serum is administered subcutaneously at a dose of 3000 IU. This dose is administered to adults and children as soon as possible after injury and up to 20 days after injury. Before introducing the serum, a test is carried out with diluted serum: intradermally in the forearm in an amount of 0.1 ml and after 20 minutes the reaction is recorded. If the diameter of the redness is less than 1 cm, the test is negative, if 1 cm or more, the test is positive.

If the test is negative, the serum is injected subcutaneously into the outer surface of the shoulder or subscapular region, first in an amount of 0.1 ml, and then the entire dose if there is no reaction. If the test is positive, serum administration is contraindicated. In this case enter ICHPS (human immunoglobulin ).

During treatment tetanus 10,000–20,000 IU is injected intravenously or into the spinal canal as early as possible. The administration is repeated until disappearance seizures . The drug can be used to treat tetanus in children from the first days of life. The dosage depends on the condition of the sick child.

Before administering the serum (in any case), antishock therapy is prepared. Given the possibility of shock developing after using the serum, the patient must be monitored for 1-2 hours. Do not use the drug if the integrity of the ampoules is damaged, there is no labeling, or if there is a change in color or transparency.

Overdose

No cases have been reported.

Interaction

With the simultaneous administration of serum and A tetanus toxin suppression of the immune response is observed.

Interaction with other immunobiological agents has not been studied.

Terms of sale

Over the counter.

Storage conditions

Temperature up to 2-8°C.

Best before date

Analogues

There are no structural analogues with the same active ingredient. AC toxoid , ICHPS (human tetanus immunoglobulin ).

Reviews of Antitetanus Serum

Tetanus – a severe infection that occurs with damage to the nervous system, which is manifested by cramps of skeletal muscles, possible development of suffocation and death. That is why children are given active tetanus prophylaxis according to the plan. DTP , ADS , ADS-M . The first complex vaccination is given to babies in the maternity hospital, and then revaccination is carried out. If you receive a full course of vaccinations antitetanus serum for simple wounds do not inject.

Passive prevention for injuries is carried out PSS (tetanus serum) or ICH PS , which is preferable for children. Prevention of the disease is very important because a person is susceptible to tetanus bacillus .

The spores of the pathogen enter through a wound, cut, burn surface and begin to produce toxin . The clinical picture of the disease sometimes occurs after the wound has healed. The incubation period is 2 - 21 days, which is why in case of injuries, it is introduced as early as possible. PSS . For severe open injuries, the drug is administered from the 3rd day of injury and no later than the 12th day. If a person is not vaccinated or there is no information about vaccinations, then in the case of grass, he is given active-passive prophylaxis - they are given toxoid and whey. There are often reviews and they are associated with the presence of adverse reactions.

• « ... My husband was injected with serum - his arm at the injection site hurt for a month».
• « ... Anatoxin is easier for the body, but serum is more difficult for the body to tolerate».
• « ... They gave me this serum - I pierced my leg with a rusty nail. I think it’s better to play it safe, since the side effects are nonsense compared to tetanus».
• « ... I had an allergic reaction after the injection - I began to shake, my temperature rose, the pain at the injection site was hellish and it was difficult to breathe. I was hospitalized».
• « ... It would be better if we vaccinated the child, since tetanus serum is less tolerated than vaccination».
• « ... The serum is very allergenic and the child was under the supervision of doctors for 2 hours after it. Everything worked out for us».
• « ... The thing is not harmless, so I refused, but the wound was received at home, not contaminated and was open».

Price of antitetanus serum, where to buy

You can buy anti-tetanus serum in many pharmacies. The cost of 5 ampoules of serum 3000 IU ranges from 688-748 rubles.

NOTE!
Information about medications on the site is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment. Before using the drug Antitetanus serum, be sure to consult with your doctor.

In most countries, including Russia, routine vaccination against tetanus is performed. As a rule, a vaccination against this disease is given together with an injection against diphtheria. In addition, mono-vaccines are used in emergency situations. Experts note that none of these vaccines provides 100% protection against tetanus. It is important to know about the possible side effects of a tetanus shot. Most often, a slight fever appears after it. Sometimes lethargy, severe weakness, and general malaise are observed. A characteristic lump appears at the injection site. All these negative manifestations quickly pass.

In some cases, an anti-tetanus injection may cause side effects such as rhinitis. A person may experience other symptoms typical of a cold. There have been cases of severe paroxysmal cough. It is possible to develop serum sickness, an allergic disease that causes fever, joint pain, and swollen lymph nodes. Hemorrhages, thrombosis, swelling, itching of the skin, sweating, headache, chills, nausea, and vomiting are observed. The disease lasts from several days to 2-3 weeks.

The most serious complications of tetanus vaccination

The most serious side effect is considered to be neurological reactions (convulsions). They are very rare, but the doctor should warn the patient about this before vaccination. Also in rare cases, anaphylactic shock has been observed - a severe, life-threatening pathological condition that refers to an immediate allergic reaction. In this condition, a spasm of the muscles of the internal organs occurs, a drop in blood pressure, and the person loses consciousness. Given the possibility of these side effects when administering tetanus serum, the doctor should provide medical supervision to the patient for an hour after the injection.

Severe complications after a tetanus injection are usually observed when the scheduled vaccination schedule is not followed, as well as when the vaccine is used of inadequate quality or if its storage is violated. The tetanus vaccine is given under the shoulder blade; as a rule, a noticeable swelling appears in this place. It is recommended to apply a sterile bandage with Levomekol ointment to it. You can seal this area with a bactericidal adhesive plaster. Also, if you experience possible discomfort after vaccination, you may be prescribed anti-allergenic drugs, for example, Suprastin. Anti-tetanus injection is contraindicated