Chapter 21: Travelers Flashcards
Travel health information, including travel health insurance recommendations, is available on the CDCs travel website where the ____ is located
Yellow Book
Which drugs can be used for TD prevention
Bismuth subsalicylate
Antibiotics if indicated
Bismuth subsalicylate should be avoided in which patients
Aspirin allergy Pregnancy renal insufficiency gout anyone taking anticoagulants
If antibiotic ppx is indicated for TD, which antibiotic is preferred
Rifaximin
Which drugs can be used for mild TD treatment
loperamide or BSS
How does loperamide work
Decreases the frequency and urgency of bowel movements
Loperamide dose for Rx and OTC
Rx: 4 mg after the first loose stool, up to a max dose of 16 mg/day
OTC: 8 mg/day
Loperamide can be used as self-treatment for up to how many days
2 days
Which drugs can be used for moderate TD treatment
Loperamide +/- antibiotics (quinolones if low resistance, azithromycin or rifaximin)
Which drugs can be used for severe TD treatment (including dysentery)
antibiotics (azithromycin preferred, quinolones or rifaximin as alternatives) +/- loperamide
What is the BSS dose for TD ppx
524-1050 mg PO QID (with meals and HS)
Which bacterium causes Typhoid Fever
Salmonella typhi
How is typhoid fever spread
food or water contaminated by the feces of someone with either an acute infection or from a chronic, asymptomatic carrier
What are the names of the Typhoid vaccines and their route of administration
Vivotif (oral, live attenuated) - remember this by the word “vivo” which means to live
Typhim Vi (inactivated IM)
remember - vivotif is the only one with an O in its name for oral
When should the oral typhoid vaccine be completed
> /= 1 week prior to travel
When should the IM typhoid vaccine be completed
> /= 2 weeks before the expected exposure
Which bacterium causes Cholera
Vibrio cholerae
What is the most common symptom of cholera
watery diarrhea, which is referred to as “rice-water stools”
What is the name for the cholera vaccine & route of administration
Vaxchora; oral solution
The CDC recommends how many booster doses for poliovirus vaccine at least 4 weeks prior to travel for adults who have previously completed a poliovirus vaccine series & who are traveling to regions where poliovirus is circulating
1 booster dose
Where should vaccination of Poliovirus be documented
On an International Certificate of Vaccination or Prophylaxis (ICVP), which also records Yellow Fever vaccine
How long does the Hep B vaccine series take to complete
3-dose series takes 6 months to complete
What should be done if a traveler is unable to complete the Hep B series before departure
Administer as many doses as possible before departure and complete the series upon return
What are the symptoms of meningococcal meningitis
Fever, severe and unrelenting HA, nausea, stiff neck (nuchal rigidity), and mental status change - all require urgent treatment
