Clinical Use of Rhesus Immune Globulin Products to Prevent Alloimmunication During Pregnancy: A primer for the health-systems pharmacist

OVERVIEW

CLINICAL USE OF RHESUS IMMUNE GLOBULIN PRODUCTS TO PREVENT ALLOIMMUNIZATION DURING PREGNANCY: A primer for the health-systems pharmacist

Therapeutic plasma products are now commonly encountered in the health-system pharmacy. One such product is rhesus immune globulin (RhIG), a hyperimmune globulin plasma derivative targeting D-antigen positive red blood cells. Clinicians may be unaware of the rationale for use, differences between products, and timing of administration of RhIG.

In the US, the widespread clinical use of RhIG has markedly reduced the incidence of hemolytic disease of the fetus and newborn (HDFN), a devastating clinical condition often resulting in death or severe morbidity. There are four RhIG products currently available, with common clinical indications but differences in certain product attributes.

Medical education regarding the clinical use of RhIG and provides information aimed at allowing for optimal use of RhIG within the modern health-system. The role of the pharmacist in the selection of a RhIG product or products for health-system use is paramount. Pharmacists are also uniquely qualified to assist in the appropriate use of RhIG therapy. Finally, pharmacists are routinely involved in the education of patients and healthcare practitioners on the appropriate use of these products. As the role of the pharmacist evolves and becomes more focused on pharmaceutical care, there is a need for greater involvement by the pharmacist in understanding drug therapy management in individuals using RhIG therapy. This program has been created to provide an intensive and comprehensive overview of the complexities of anti-D immune globulin use geared specifically to the needs of pharmacists.

OBJECTIVES

At the end of this program, participants should be able to:

  1. Review the immunologic basis and emerging therapeutic roles for Rho(D) immune globulin (RhIG);
  2. Describe differences between the different RhIG products in the US market;
  3. Review guiding principles for safe, effective and appropriate use of RhIG.

Faculty

Eric M. Tichy, PharmD, BCPS, FCCP
Senior Clinical Specialist
Yale-New Haven Hospital
New Haven, Connecticut

Eric M. Tichy, PharmD, BCPS, FCCP, is Senior Clinical Specialist for Solid Organ Transplant at Yale- New Haven Hospital in New Haven, Connecticut. He is also Adjunct Clinical Instructor of Pharmacy Practice at Duquesne University Mylan School of Pharmacy in Pittsburgh, Pennsylvania; Northeastern University School of Pharmacy in Boston, Massachusetts; and the University of Connecticut School of Pharmacy in Storrs, Connecticut. Dr. Tichy completed his doctor of pharmacy degree in 2001 at the University of Connecticut School of Pharmacy and served his pharmacy practice residency at Yale-New Haven Hospital. A board-certified pharmacotherapy specialist, Dr. Tichy is active in the American Society of Transplantation, where he acts as Chair of the Transplant Pharmacist Community of Practice, and also in the American College of Clinical Pharmacy, where he previously was the Chair of the Annual Meeting Program Planning Committee. In addition, he is a Network Facilitator for Immunology/Transplant for the American Society of Health-System Pharmacists. A Fellow of the American College of Clinical Pharmacy, Dr. Tichy serves on the editorial board of Progress in Transplantation, American Journal of Health-System Pharmacy, and Pharmacy Practice News, and also as reviewer for several peer-reviewed journals. He has published over 20 journal articles and book chapters and frequently appears as an invited lecturer on such topics as intravenous immune globulin therapy, organ transplantation pharmacotherapy, and other pharmacy-related topics.

David Reardon, PharmD, BCPS
Clinical Pharmacist, II
Yale-New Haven Hospital
New Haven, Connecticut

David P. Reardon, PharmD, BCPS, is a Solid Organ Transplant Clinical Pharmacist at Yale-New Haven Hospital in New Haven, CT, and Vice President of PharmD Press, a Limited Liability Corporation in Minneapolis, MN. David received his BS and PharmD from North Dakota State University and completed his PGY1 Pharmacy Practice Residency at Mayo Clinic Health System-Mankato in Mankato, MN. He completed a PGY2 Critical Care Pharmacy Residency at Brigham and Women’s Hospital in Boston, MA where he also had a primary role in the development of an adult ECMO program and implemented a Hemostatic and Antithrombotic Stewardship. David serves as a preceptor for pharmacy students and PGY1-2 residents at Yale-New Haven Hospital and is an adjunct faculty member for the University of Connecticut School of Pharmacy. He has published in the areas of critical care, glycemic management, anticoagulation and blood products and serves as a contributing editor for resident publications for the American Journal of Health-System Pharmacy.

CONTINUING EDUCATION

ACCREDITATION STATEMENT

This program is accredited by ACPE for 0.1 (1 hours) CEUs of Home Study. TG Medical Education LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

ACTIVITY TYPE

Knowledge (0454-0000-15-003-H01-P); Release date is March 15, 2015

REQUIREMENTS FOR CE CREDIT

All participants are required to take a post-test after reading the home study materials. All those achieving a score of 70% or higher will be directed to the program evaluation form. For those scoring less than 70%, you will be given the opportunity to re-test in order to achieve a passing grade. After the completion of the program evaluation, participants can print their CE certificates. Please note that when completing the evaluation, you must include your correct NABP eID so that the credits can be transferred to the NABP within 60 days of the completion of the post-test.

FACULTY DISCLOSURES

Eric M. Tichy, PharmD, BCPS, FCCP has disclosed the following relevant affiliations or financial relationships with a commercial interest: he is a consultant and speaker for Baxter Bioscience and Grifols USA.

David Reardon, PharmD, BCPS has no relevant conflicts of interest to disclose.

ACKNOWLEDGEMENT OF COMMERCIAL SUPPORT

This activity is supported by an educational grant from Grifols.

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