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Neonatal Pharmacology > Immunizations > Flashcards

Immunizations Flashcards

1
Q

Preemies should receive their immunizations when?

A

At same Chronological age as term infants

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2
Q

True/False: Preemies have lower absolute primary antibody responses vs term babies?

So, they need what?

A

True–despite this, many achieve adequate protection

Repeated doses (like terms)

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3
Q

When should HBV and HBIG be given to a baby of an HBsAg positive mom?

A

from birth-12 hours of life

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4
Q

When should HBV be given to a baby of an HBsAg neg mom?

A

Birth-Discharge (2 months)

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5
Q

What should be given to a baby of a mother with unknown HBsAg status?

A

HBV for sure + HBIG (if <2000 gms w/in 12 hrs) unless mom’s status can be determined.
(if >2000 gms have up to 7 days to verify status before HBIG needs to be given)

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6
Q

True/False: Infants respond to Hep B Virus w/high immunogenic effects when infected during delivery or household contact w/those infected.

A

True

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7
Q

___% of kids who contract Hep B–>chronic Hep B w/significant Liver dz.

A

90%

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8
Q

___% of mothers w/Hep B aren’t receiving tx that would prevent infection of their NB

A

20%

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9
Q

Of infants born to mom’s who are Heb B +, ___-___% would NOT become infected if given HBV + HBIG w/in 24 hrs.

A

85-95%

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10
Q

Do single dose HBV contain Thimerasol?

A

No

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11
Q

In preterm or LBW babies, does the birth dose of Hep B count towards their full course?

A

No, does not count as 1st dose.

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12
Q

What are the most frequently reported s/e’s of HepeB vaccine?

A

Fever

Pain at injection site

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13
Q

Is Anaphylaxis common w/HBV?

A

No

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14
Q

HBIG provides what type of immunity?

A

Passive immunity to HepB.

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15
Q

Which infant’s are given HBIG, why?

A

Those w/HBsAg + moms

They have high risk of being infected and becoming chronic carriers.

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16
Q

How is HBIG prepared?

A
  • From Hyper-immunized Donors whose plasma is known to contain a high concentration of Anti-HBs (high aby titers)
  • It is pooled
  • All donors are HBsAg neg and HIV aby neg
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17
Q

What % of infants given HBV & HBIG w/in 1st few months do NOT become carriers?

A

94%

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18
Q

What are the s/e’s of HBIG?

A

Pain -injection site

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19
Q

Synagis (Palivizumab) is a __________ antibody that inhibits ____ replication by binding to the ___ glycloprotein on the surface of the virus to keep it from invading the lower respiratory tract.

A

Monoclonal antibody
RNA replication
F-glycoprotein

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20
Q

Synagis reduces RSV-related hospitalizations by ____%?

A

55%

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21
Q

The mean T2 of Synagis is?

A

~20 days

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22
Q

Adequate titers of Synagis last about?

A

1 month

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23
Q

Does synagis interfere w/vaccines?

A

No

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24
Q

RSV is transmitted through _____ to _____ migration beginning in the ______ respiratory tract and migrating to the _____ respiratory tract

A

cell to cell
Upper
Lower

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25
Q

Synagis blocks:

A

Cell to cell transfer of RSV

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26
Q

Who qualifies?

A
  • Preterm born <29 weeks GA & younger than 12 months at season’s start
  • Those w/hemodynamically sig Cong. Heart Dz & <12 months
  • CLD 1st yr: (<32 wks + >21% FiO2 at least 28 days post-birth)
  • CLD 2nd yr: only those who cotinue to require medical support (chronic steroid tx, diuretic tx, O2) w/in 6 months of season start
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27
Q

When should qualifying babies in the NICU receive their 1st dose of Synagis?

A

Before discharge from the hospital

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28
Q

We are most concerned about which babies getting RSV?

A

Preterm, CLD, Hemodynamically sig. heart dz, CHF, PPHN, Cong airway abnormalities, Neuromuscular Dz

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29
Q

What are the 2 most discussed risk factors for developing RSV?

A
  1. Exposure to other children >4 hrs/wk (2> unrelated children)
  2. Sibs <5 y/o
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30
Q

What are the other risk factors for development of RSV?

A

Tobacco smoke exposure, LBW, Lack of Br feeding, Family Hx Asthma

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31
Q

When would you NOT want to give Synagis?

A

Plt count <40k

32
Q

What is the most commonly reported s/e of Synagis?

A

Mild transient Erythema, Pain and Induration of injection site

33
Q

If a baby getting RSV prophyaxis w/Synagis gets RSV, should Synagis injections continue?

A

Yes.

34
Q

True/False: Inactivated Polio Vaccine is the only one available in the U.S.

A

True

35
Q

How does IPV work?

A

Produces specific antibodies to Poliomyelitis

36
Q

What is the most common s/e of IPV?

A

Erythema and tenderness at injection site

37
Q

Have there been serious adverse events of IPV?

A

No

38
Q

Prevnar/PCV 13 contains how many serotypes of Pneumococcus Pneumoniae?

A

13

39
Q

Bedsides Pneumonia, the Peumococcal vaccine also provides protection against what?

A 
Otitis Media
(7 types)
40
Q

What are the most commonly reported s/e’s of Pneumococcal vaccine?

A

Injection site swelling/redness

Fever (w/in 1-2 days; particularly w/conjugate vaccination)

41
Q

DTap in the US is now exclusively what type?

A

Purified, acellular-component Pertussis

42
Q

What are the most commonly reported s/e’s of DTaP vaccine?

A 
Local &amp; Febrile reactions
Allergic Reactions
Seizures
Hypotonic-Hyporeponsive episodes
Fever
Prolonged crying (the most common)
43
Q

There is an a/w increased _______ after DTaP vaccination. What should be monitored and for how long?

A

Apnea
CV monitoring
min 48 hrs-per unit policy

44
Q

How many single types of HIB vaccines are available?

Conjugate?

A

3-single

2-conjugate

45
Q

What does the HIB vaccine prevent?

A

Serious systemic bacterial dz: Meningitis, Sepsis, Septic Arthritis, Epiglottitis, Osteomyelitis, Pericarditis, Pneumonia (capsular strains of type B–H.Influenza)

46
Q

Does HIB provide protection in the first 2 weeks after administration?

A

No

47
Q

How many Rotavirus Vaccines are available in the U.S.?

How many in the series?

A

2
1-3 dose
1-2 dose

48
Q

All Rotavirus vaccines are what form?

A

Oral

49
Q

What is the most common cause of gastroenteritis in infants and children?

A

Rotavirus

50
Q

When is the 1st vaccine given?

A

6 wks–14 wks 6 days

51
Q

World-wide, Rotavirus causes _____ deaths/year in children <5 y/o.

How many in the U.S.?

A

500,000 (1/2 Million)

Only a few in the U.S.

52
Q

Rotavirus doses should be given by ___ months each dose separated by ____ weeks

A

8 months

4 weeks

53
Q

Rotavirus vaccine has done what?

A

Reduced ER visits and Hospitalizations

54
Q

Rotavirus vaccine is proven safe & effective except in kids with what conditions?

A

Pre-existing, chronic GI dz

55
Q

There are ___ Influenza vaccines. Both are _____ containing 3 virus strains.

A

2

Multivalent

56
Q

Can the Influenza vaccine cause the flu?

A

No, it contains non-infectious viruses and can not produce active Influenza infection.

57
Q

What are some s/e’s of the Flu vaccine?

A

Headache, Fever, Nausea, Lethargy, Muscle aches, Chills

58
Q

Starting at what chronological age should all infants receive the flu vaccine?
How is it dosed in infants?

A

6 months

2 doses 1 month apart

59
Q

Who is at especially high risk?

How can they be helped?

A

Preterm infants

Family home herd immunity

60
Q

Hep A Vaccine is given by ___ inactivated vaccines available in the U.S.

A

2

61
Q

Is there preservative in Hep A vaccine

A

No

62
Q

When is Hep A vaccine given?

A

2 doses one at 12 months, second 6-12 months later

63
Q

What are the adverse events of Hep A

A

Mild pain and induration at injection site

64
Q

MMR provides protection against?

A

Measles, Mumps, Rubella

65
Q

What does MMR also protect against if it is an MMRV vaccine?

A

Varicella

66
Q

When is MMR 1st dose?

A

12-15 months

67
Q

When is MMR second dose?

A

4-6 yrs

68
Q

Is MMR a live virus vaccine?

A

yes, it is live

69
Q

In general combination vaccines need to be given ___ weeks apart.

A

4 weeks

70
Q

What are the adverse effects of MMR vaccine

A 
Fever >103 (5-15%)
Transient Rashes (5%)
Febrile Seizures (1:3000--1:4000)
Transient Thrombocytopenia (1:22k--1:40k)
71
Q

True/False: Varicella is a live-attenuated vaccine?

A

True

72
Q

When is Varicella given?

A

12-15 months

73
Q

What are the adverse effects of Varicella Vaccine?

A

Injection site reactions: pain, redness, swelling

Localized rash

74
Q

All vaccines:

Do not give if platelet count

A

40K
3/4-1” & 25-27 gauge
3/8-5/8” & 23-25 gauge
2 y/o & walking

75
Q

Antipyretics given at the time of vaccination may do what?

A

Decrease immune response to the vaccine.

May be given for significantly elevated temps & local discomfort

Neonatal Pharmacology (17 decks)

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