Latin, Serum Antidiphthericum Purificatum

Eng., Purified Antidiphtheric Serum. Synonyms, Antidiphtheric Globulins, Concentrated Diphtheria Antitoxin, etc. A solution in physiological solution of sodium chloride of certain antitoxic substances obtained from the blood-serum or plasma of the horse, Equus Caballus, or other large domestic animal, which has been properly immunized against diphtheria toxin.

Average Dose

Hypodermic, 10,000 units; protective, 1000 units.

Very large doses are sometimes given, particularly in laryngeal infection. The dose should be based on the probable amount of blood in the patient (size of patient).

The serum is best injected into the loose connective tissue under the skin, care being taken not to inject into the skin. Probably the most desirable site is over the lower ribs in about the anterior axillary line, or a little to the front of this. The patient is then able to lie on the back or either side.

The area should be cleaned, the site of injection touched with tincture of iodine, the skin lifted with the thumb and index finger of the operator's left hand, and the needle inserted with a firm, rapid motion. The pain is less if the liquid is injected slowly. The puncture may be covered with a strip of sterile adhesive plaster for a few hours.

Serum Sickness

Considerable pain at the site of injection is often experienced for a few hours. Sometimes, particularly when the patient has recently been given a serum, toxic symptoms may develop. Acute anaphylaxis is rare, but an elevation of temperature and general discomfort occur often. The most common manifestation is edema and urticaria, developing between the fifth and eighth days after the injection. Sodium bicarbonate, internally and externally, has been extensively used. A hypodermic of 10 to 15 minims (for an adult) of Solution of Adrenalin Chloride (1 to 1000) seems to give excellent results.