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1. Immunoglobulin (Ig) is isolated from plasma pooled from a large number of healthy donors to ensure that

A. The final product is virus-free B. The purified Ig contains no IgA C. The final product contains a large and diverse antibody repertoire D. All anticomplement activity is eliminated E. Unsure

2. Pharmacoeconomic studies have found that shifting from hospital-based to home-based Ig infusion, or changing from an intravenous immunoglobulin (IVIG) to a subcutaneous immunoglobulin (SCIG), may result in

A. Significantly higher overall health care costs B. No significant change in overall health care costs C. Significantly lower overall health care costs D. No comparative pharmacoeconomic data are available to decide E. Unsure

3. Patients with selective IgA subclass deficiency who have antibodies to IgA

A. Can safely receive Ig products since all IgA is removed during the manufacturing process B. Can receive Ig products if administered at a low infusion rate and under a physician's supervision C. Can receive Ig products following premedication with H1 antihistamines D. Should only receive specially prepared very-low-IgA products to avoid an anaphylactic response E. Unsure

4. Your patient, who has been receiving SCIG for the past year, complains about the need for frequent self-injections but does not want to change to IVIG administration. You suggest he try a facilitated SCIG product because the recombinant hyaluronidase it contains is designed to

A. Minimize immunogenicity B. Result in a lower incidence of local adverse reactions C. Allow for equivalent doses of SCIG to IVIG with similar frequency (q3-4 weeks), administered at one or two SC sites in less time with similar pharmacokinetics to IVIG D. Decrease injection pain E. Unsure

5. Careful consideration of the additives is recommended prior to selection and use of Ig products since in some patients stabilizers like L-proline may cause

A. Cardiac toxicity B. Hyperprolinemia C. “Rate-related” toxicities D. Hypercoagulation E. Unsure

6. Your patient, who has been receiving IVIG every 28 days, presents with fatigue and upper respiratory symptoms during the fourth week of her dosing cycles. This may result from a progressive decline as IgG trough levels are approached, known as

A. Pharmacokinetic two-compartment model B. Steady-state equilibrium C. Normalization D. Wear-off effect E. Unsure

7. Your patient with pre-existing renal dysfunction has been receiving an IVIG product but recently experienced rash and hypotension, which you considered to be “rate-related” toxicities. She asks about changing to a different IVIG product since all such agents are the same. You point out that

A. All IVIGs are chemically identical and therefore should be interchangeable B. Adjustment of the infusion rate and/or use of preinfusion medications is advised C. Such toxicities likely arise due to use of products with a high pH D. Her side effects are probably related to the presence of contaminating antibodies against blood group proteins, so a change is indicated E. Unsure

8. To reduce the risk of thrombosis and renal dysfunction, practitioners should administer IVIG

A. Using a minimum dose and infusion rate B. Only in patients younger than 65 years of age C. Using products with a pH of less than 5.5 D. Using products with an osmolality greater than 370 mOsm/kg E. Unsure

9. What types of adverse events are seen more commonly with SCIG compared to IVIG?

A. Local reactions B. Systemic reactions C. Hepatic toxicities D. Thromboembolic events E. Unsure

10. Pharmacist-driven IVIG stewardship programs have been shown to

A. Negatively affect guideline compliance B. Indirectly increase overall health care costs C. Aid in patient education regarding appropriate Ig use D. Reduce treatment costs and aid in utilization management E. Unsure

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

{{recommendationsA.Title}}

{{recommendationsB.Title}}

1. Immunoglobulin (Ig) is isolated from plasma pooled from a large number of healthy donors to ensure that

2. Pharmacoeconomic studies have found that shifting from hospital-based to home-based Ig infusion, or changing from an intravenous immunoglobulin (IVIG) to a subcutaneous immunoglobulin (SCIG), may result in

3. Patients with selective IgA subclass deficiency who have antibodies to IgA

4. Your patient, who has been receiving SCIG for the past year, complains about the need for frequent self-injections but does not want to change to IVIG administration. You suggest he try a facilitated SCIG product because the recombinant hyaluronidase it contains is designed to

5. Careful consideration of the additives is recommended prior to selection and use of Ig products since in some patients stabilizers like L-proline may cause

6. Your patient, who has been receiving IVIG every 28 days, presents with fatigue and upper respiratory symptoms during the fourth week of her dosing cycles. This may result from a progressive decline as IgG trough levels are approached, known as

7. Your patient with pre-existing renal dysfunction has been receiving an IVIG product but recently experienced rash and hypotension, which you considered to be “rate-related” toxicities. She asks about changing to a different IVIG product since all such agents are the same. You point out that

8. To reduce the risk of thrombosis and renal dysfunction, practitioners should administer IVIG

9. What types of adverse events are seen more commonly with SCIG compared to IVIG?

10. Pharmacist-driven IVIG stewardship programs have been shown to

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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{{recommendationsB.Title}}

1. Immunoglobulin (Ig) is isolated from plasma pooled from a large number of healthy donors to ensure that

2. Pharmacoeconomic studies have found that shifting from hospital-based to home-based Ig infusion, or changing from an intravenous immunoglobulin (IVIG) to a subcutaneous immunoglobulin (SCIG), may result in

3. Patients with selective IgA subclass deficiency who have antibodies to IgA

4. Your patient, who has been receiving SCIG for the past year, complains about the need for frequent self-injections but does not want to change to IVIG administration. You suggest he try a facilitated SCIG product because the recombinant hyaluronidase it contains is designed to

5. Careful consideration of the additives is recommended prior to selection and use of Ig products since in some patients stabilizers like L-proline may cause

6. Your patient, who has been receiving IVIG every 28 days, presents with fatigue and upper respiratory symptoms during the fourth week of her dosing cycles. This may result from a progressive decline as IgG trough levels are approached, known as

7. Your patient with pre-existing renal dysfunction has been receiving an IVIG product but recently experienced rash and hypotension, which you considered to be “rate-related” toxicities. She asks about changing to a different IVIG product since all such agents are the same. You point out that

8. To reduce the risk of thrombosis and renal dysfunction, practitioners should administer IVIG

9. What types of adverse events are seen more commonly with SCIG compared to IVIG?

10. Pharmacist-driven IVIG stewardship programs have been shown to

« Return to Activity

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