GAMMAGARD SD (lyophilized powder) (IV)

ALWAYS establish patent IV access and flush PRIOR to mixing medication

ALWAYS establish IV access prior to mixing any meds

ALWAYS make sure you have everything you need to complete infusion before you begin

ALWAYS confirm your medication dose against the medication label and orders

ALWAYS reach out to us first (not the Pharmacy) with any questions

NEVER tell a Pt you have not given a particular medication before

Obtain a clear/clean space to prepare Gammagard SD
Be sure all the necessary supplies are available to complete infusion from beginning to end. You will need: IV start kit, 18-gauge needles, 60 my syringes, Alcohol wipes, Sterile water for Injection (SWFl) vial(s), pump and IV tubing with at least a 15-micron filter, vented spike
Discard the transfer device supplied in the Gammagard SD box
Gammagard S/D may be reconstituted to a 5% or 10% solution; verify the prescribed concentration ordered, prior to adding diluent
Diluent Volume to be used
- For 5% concentration use entire content of SWFl vial
  - 10 g bottle use 192 ml
  - 5 g bottle use 96 ml
- For 10% concentration draw up the following amount of SWFl vial
  - 10 g bottle draw up 96 ml diluent
  - 5 g bottle draw up 48 ml diluent
With 18-gauge needle and 60 ml syringe, draw up the required volume of diluent to be used and insert the 60 ml SWFl-filled syringe into center of rubber stopper of the Gammagard SD vial at a 45-degree angle
- This will prevent the product from foaming as the SWFL flows along the walls of the glass bottle, rather than on the Gammagard concentrate
Once diluent added to the vial wet the dried material by tilting or gently rotating the vial. It may take 20-40 minutes for Gammagard SD to become fully dissolved. Gently swirl vial on flat surface until solution is clear. Let sit until it appears evenly distributed, clear and fully dissolved
- DO NOT SHAKE VIALS to avoid foaming

Take baseline vitals and document basic assessment
Infuse directly from the Gammagard SD vial using a tubing w a filter size of at least 15 microns.
- Administer each Gammagard SD vial sequentially
Begin infusion following rates set by pharmacy
- Rates will be on orders or on a rate sheet sent with the medication or on the medication label
- Use HHC standard rates if no rates are given:
  - 30ml/hr X 15 minutes
  - 60ml/hr X 15 minutes
  - 90 ml/hr X 15 minutes
  - 120ml/hr X 15 minutes
  - 150ml/hr X 15 minutes (Max rate until infusion ends)
Monitor patient for any adverse reactions
Record vitals every 15 minutes after infusion start, AND 5-10 minutes post infusion
Record lot numbers and expiration dates for vials used
Disconnect patient, flush line, and remove IV
- Place pressure bandage at site
Clean and dispose of used supplies

Prescribing Info: Gammagard SD; Gammagard SD Prescribing Info