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Studying for the Naplex > Chapter 20: Immunizations > Flashcards

Chapter 20: Immunizations Flashcards

1
Q

What are vaccines?

A

Vaccines are injections containing strains of the disease given to the patient so that they develop antibodies and are ultimately immune to the disease.

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2
Q

What are the 2 methods in which vaccines prevent the spread of the disease?

A
  1. The vaccinated person will now have antibodies that will fight against the disease when exposed to it.
  2. Herd Immunity: When the majority of the population is vaccinated, it will be much harder for the disease to spread to those unvaccinated.
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3
Q

What are some information resources for vaccines?

A

FDA
ACIP
CDC
The Pink Book

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4
Q

Sources of information for patients regarding vaccines

A
  1. CDC Website

2. Immunization Advisory Coalition Website

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5
Q

Do vaccines cause autism?

A

No, they absolutely do not. This is a gigantic myth. Evidence of autism can be found even before the baby is born by looking at brain structures such as the pre-frontal cortex. There is also a myth that thimerosal causes autism. There is absolutely no evidence that it does.

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6
Q

What can vaccines possibly contain that religious people would not be fond of?

A

Gelatin. This is a porcine-derived product (from pigs). Some religions forbid the consumption of pork. Keep that in mind.

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7
Q

What exactly is immunity?

A

Immunity is the ability for the body to differentiate between its internal structures and foreign substances. Foreign substances that invade into the body are known as antigens. Upon detection, the human body develops antibodies to destroy them.

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8
Q

What are the two types of immunity?

A
  1. Active: This is when the body creates its own antibodies to fight the antigens. This usually happens when the person is exposed to the disease or receives a vaccines.
  2. Passive: This is when the person receives antibodies from another person. An example of this would be mother to child.
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9
Q

What are the two types of vaccines?

A
  1. Live-Attenuated: This is a strain of the actual virus and it is capable of replicating in the individual. Because of that, it will stimulate a strong response in the patient.
  2. Inactivated: This is a fraction, modified version of the actual disease. It will not create as strong of a response in the patient. Because of that, it is recommended for immunocompromised and pregnant patients. Live-attenuated vaccines could cause serious harm in these patients.
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9
Q

What are the two types of vaccines?

A
  1. Live-Attenuated: This is a strain of the actual virus and it is capable of replicating in the individual. Because of that, it will stimulate a strong response in the patient.
  2. Inactivated: This is a fraction, modified version of the actual disease. It will not create as strong of a response in the patient. Because of that, it is recommended for immunocompromised and pregnant patients. Live-attenuated vaccines could cause serious harm in these patients.
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10
Q

What are some examples of non-live vaccines?

A 
Polysaccharide
Conjugated
Recombinant
mRNA
Toxoid
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11
Q

What are some examples of live vaccines?

A 
MMR
Intranasal Influenza
Cholera
Rotavirus
Oral typhoid
Varicella
Yellow Fever
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12
Q

What are some things to know about timing when it comes to vaccines?

A 
Most vaccines (Whether live or non-live) can be given together on the same visit. 
Some vaccines have certain schedules and timings. It's important to meet those timings but if a vaccine is delayed, that's ok, it does not diminish the response. It would actually be worse if it were given earlier than it should be. Later is better than early.
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13
Q

What needs to be known about antibody-containing products and live vaccines?

A

Live vaccines can have severe interactions with antibody-containing products. Antibody-containing products should be separated from live vaccines by at least 3 months and can even be up to 11 months.

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14
Q

What are some things to know about vaccines when it comes to babies?

A

Babies carry antibodies from the mother and those antibodies usually completely wear-off by about 12 months after birth. After those 12 months after birth, live vaccines are finally given to them. The only exception is rotavirus which is given about 3 months after birth because its been proven to prevent rotavirus when vaccinated at this time. Non-live vaccines can be given right at birth but are usually given about 2-3 months after birth. The only exception is hepatitis B, which is given right at birth.

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15
Q

What is the tuberculin skin test?

A

This is a test performed to determine if a patient has latent tuberculosis. However, this test can cause false-negative results. To lower the chances of this happening, the following are done:

  1. Give the vaccine and perform the test on the same day.
  2. Give the vaccine, 4 weeks later, perform the tuberculin skin test.
  3. Perform the tuberculin skin test, look at the results 48-72 hours later and if necessary, give the vaccine.
16
Q

What are some things to know about when it comes to vaccines adverse events?

A

Vaccines are capable of causing adverse events whether they are mild (Rash, soreness) or even life-threatening (anaphylaxis). Before obtaining the vaccine, the patient should be checked to see if they have any contraindications towards the vaccine. They also fill out a questionairre before obtaining the vaccine.

17
Q

What should be done right after a patient obtains their vaccine?

A

They should be observed for 15 minutes to see if they develop any adverse reactions (Dizziness, syncope, shortness of breath, etc…)

18
Q

In the event that a patient develops an adverse reaction after receiving their vaccine, where should the pharmacist report the event?

A

The FDA’s Vaccine Adverse Event Reporting System (VAERS)

19
Q

What are local reactions?

A

This is a reaction occuring at the site of injection (Rash, soreness, pain)

20
Q

What are systemic reactions?

A

These are symptoms from the vaccine such as fever, malaise, myagia, etc…

21
Q

Can the flu shot cause the flu?

A

No, it cannot. This is because it is an inactivated form of the virus. Live vaccines (Such as the intranasal influenza) can cause more mild-systemic reactions. They usually occur about 3-21 days after the vaccine was given.

22
Q

If a patient develops a mild allergic reaction towards a vaccine, how should they be treated?

A

Diphenhydramine (Benadryl-OTC) or Hydroxyzine (Vistaril-Prescription)

23
Q

In an emergency allergic reaction situation, what do you do?

A
  1. Call 911
  2. Administer epinephrine pen 0.1 mg/kg (1:1000 dilution). Administer about 1-3 doses in a span of 5-15 minutes.
  3. If they have swelling or itching, give them diphenhydramine (Benadryl). Do not give them this if the have trouble swallowing, they can choke.
  4. If their blood pressure is low, lay them on their back on the floor and lift their legs up. Check their blood pressure about every 5-15 minutes. Do not lay them down on the floor if they have trouble breathing.
  5. Perform CPR if necessary.
  6. Report the event in the FDA’s Vaccine Adverse Event Reporting System.
24
Q

What are some important live-vaccine contraindications to keep in mind?

A
  1. The patient is immunocompromised
  2. The patient is pregnant
  3. The patient had a previous anaphylactic reaction to that vaccine.
25
Q

What is the most common vaccine preventable disease in the U.S?

A

Influenza

26
Q

How many types of influenza are there? What are they?

A

Two types: Influenza A and Influenza B.

27
Q

What are the surface antigens of influenza A?

A

Influenza A also has subtypes. These subtypes depend on their surface antigens which are hemagluttinin and neuraminidase.

28
Q

How often is the influenza vaccine given?

A

The influenza vaccine is given anually. The influenza virus changes a little bit every year by antigenic drift. Every 30 years, it changes so dramatically that it is capable of being a novelty virus and causing a pandemic.

29
Q

How is the influenza virus spread?

A

It is spread from person to person, mainly through respiratory droplets.

30
Q

What are symptoms of the flu?

A

Fever, myalgia, headache, malaise, rhinitis

31
Q

What is the most common cause of otitis media, pneumonia, meningitis, and blood stream infections in children?

A

S. pneumoniae, also known as pneumococcus.

32
Q

What is the most common cause of otitis media, pneumonia, meningitis, and blood stream infections in children?

A

S. pneumoniae, also known as pneumococcus.

33
Q

What is Otitis Media?

A

Inflammation inside of the ear

34
Q

What is meningitis?

A

Inflammation of the brain and spinal cord membranes. Symptoms include headache and stiff neck.

35
Q

What is pneumonia?

A

This is when the air sacs in the lungs get filled up with pus or fluids. The patient then has trouble breathing.

36
Q

How many pneumococcal vaccines are there? What are they?

A

There are two types:

 1. PCV13: A conjugate vaccine
 2. PPSV23: A polysaccharide vaccine
      - Children below the age of 5 obtain the PCV13 vaccine because they are unable to tolerate polysaccharide vaccines.
37
Q

.What patients qualify for PCV13?

A
  1. Immunocompromised patients above the age of 6
  2. Patients above the age of 65 if they speak with their provider and the provider approves it. Usually, PPSV23 is the vaccine for patients above 65 years of age.
38
Q

What patients qualify for PPSV23 vaccine?

A
  1. Patients above the age of 65 (the main one)

2. Select patients between the ages of 2-64.

Studying for the Naplex (13 decks)

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