A patient with Guillain-Barré Syndrome has been admitted and advised immunoglobulin therapy. Immunoglobulin can be administered through which of the following routes?

Appeared in: RML 2023

Explanation

Immunoglobulin (Ig) therapy can be administered via three main routes: intravenous (IV), subcutaneous (SC), and intramuscular (IM).
The choice of route depends on the clinical indication, the required dose, and patient-specific factors.
While Intravenous Immunoglobulin (IVIG) is the standard for acute conditions like Guillain-Barré Syndrome, SCIG and IMIG are used for other conditions, making all three valid routes for Ig administration in general.
Therefore, selecting 'All of the above' correctly identifies all possible administration routes for immunoglobulin therapy.

Option A: This is incorrect because it is not the only route. While IV is the standard for GBS, immunoglobulin can also be given subcutaneously and intramuscularly for other indications.
Option B: This is incorrect as it excludes the IV route, which is used for GBS, and the IM route, used for specific prophylaxis. SC is typically used for long-term replacement therapy.
Option C: This is incorrect as it excludes the IV and SC routes, which are more commonly used for immunomodulation and replacement therapy. The IM route is now primarily reserved for specific post-exposure prophylaxis.

Clinical Relevance

Nursing practice connection: Use the key finding related to Routes of Immunoglobulin (Ig) Administration to guide bedside assessment, documentation, and the next nursing action.
Nurses must be knowledgeable about the different Ig formulations and their approved routes to ensure patient safety and therapeutic efficacy.
Administering a product via the wrong route (e.g., a concentrated SCIG or IMIG product intravenously) can cause severe adverse reactions.
Patient education is a key nursing role, especially for patients on SCIG who will be self-administering at home.

How to Approach the Question

First, identify the core of the question, which is about the possible administration routes for immunoglobulin therapy in general.
Recognize that the patient's diagnosis (Guillain-Barré Syndrome) provides context for one specific use (IVIG) but does not limit the question to only that condition.
Evaluate each option based on general knowledge of pharmacology and immunology.
Recall that Intravenous (IV) is used for acute, high-dose therapy.
Recall that Subcutaneous (SC) is used for chronic, long-term replacement.
Recall that Intramuscular (IM) is used for specific post-exposure prophylaxis.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 1357-1359, 1588-1590

Practise the full RML 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.