Pharm Exam 2: Ear/Eye/Health Promotion

Question 1

Blepharitis

Answer 1

Eyelid margin infection/inflammation

Complications: dry eyes

Symptoms: irritated red eyes, burning sensation, increases tearing, blinking, photophobia, eyelid sticking, contact lens intolerance, eyelid margins are red, greasy, crusted, eyelid dermatitis, matted scaly eyelids

More common in adults; chronic in nature

Rarely cause vision troubles

Causes: Staphylococcus aureus, eye makeup, contact lens buildup, smoke, smog, chemicals, meibomian glands, inflammation/hypersecretion of sebaceous glands

No cure

Goal of treatment: control symptoms and prevent secondary complications

Question 2

Blepharitis

Treatment

Answer 2

Bacitracin (Baciguent-polypeptide antibiotic
Apply fingertip size amount to affected are 1-3 times daily
Side effects: itching, burning, inflammation

Erythromycin Ophthalmic Ointment 0.5% (macrolide abx)
Apply 1cm to infected eye up to 6x daily
Side effects: minor ocular irritation, redness, hypersensitivity
Pregnancy Cat B

Question 3

Blepharitis

Agent selection

Answer 3

First line:
Erythromycin 0.5% ophthalmic ointment (cause blurry vision)

Bacitracin 500 units ointment (cause blurry vision)

Ophthalmic fluoroquinolone solution (Besifloxacin, gatifloxacin, levofloxacin, moxifloxacin

Second line: refer to ophthalmologist

Question 4

Blepharitis

Education

Answer 4

Improve eyelid hygiene: warm massages, occasional abx use, no contact lens use during flareups

Question 5

Conjunctivitis (Pink eye)

Answer 5

Most common cause of red, painful eye

Inflammation of bulbar conjunctiva or palpebral conjunctival.

Symptoms: consistent inflammation of conjunctiva, red eyes, swollen conjunctiva, discharge from eyes

Normal pupil exam, normal vision

All types are self-limiting and usually resolve without tx in 2-5 days. Meds can speed up process, but abx NOT necessary usually

Pts should use cold compress and lubricants (artificial tears) for comfort

Topical vasoconstrictors and antihistamines can be used for severe itching (not usually indicated)

Question 6

Conjunctivitis
Bacterial
More common in children
contagious

Answer 6

Cause: gram-positive Staph or Strep, gram-negative Moroxella/Haemophilus, Chlamydia or Gonorrhoeae

Transmission: contact with eye by fingertip, neonates by infected mother, contaminated pool

Symptoms: rapid onset of conjunctival redness
swelling of the eyelid
usually in one eye first and spread to other eye in 2-5 days
Grittiness/irritation, stringy, opaque, grayish or yellowish mucopurulent discharge, sticky lids, lid crusts
Foreign body sensation

Question 7

Conjunctivitis
Viral
contagious

Answer 7

Cause: upper resp tract infection, common cold, sore throat.

Symptoms: excessive watery discharge, itchiness
foreign body sensation, peripheral injection, usually starts in one eye

Treatment: no effective tx
Risk of spreading infection
Topical antihistamines, artificial tears, cool compress

Question 8

Conjunctivitis

Allergic

Answer 8

Cause: immunoglobulin-E mediated release of mast cells in conjunctiva

Symptoms: watery discharge, itching, burning, both eyes, excessive blinking

Treatment
Minimize allergen
First line: ophthalmic antihistamines alcaftadine or emedastine

Second line: topical corticosteroid

Third line: mast cell stabilizer -> azelastine, epinastine, ketotifen, olopatadine; opthalmic ketorolac

All pts can use cool compress and artificial tears

Question 9

Conjunctivitis
Bacterial
Treatment
Ointments preferred for children, poor compliance difficult admin

Answer 9

First Line
Erythromycin Ophthalmic Ointment 0.5% (macrolide)
1cm directly to eyes up to 6x daily
Side effects: minor ocular irritation, redness, hypersensitivity
Preg Cat B

Polymyxin B sulfate & trimethoprim Ophthalmic solution
Aeroci gram-positive and gram-negative tx
1 gtt q3h for 7-10 days
Side effects: local irritation, redness, burning, stinging, itching
Preg Cat C

Second line- Fluoroquinolones
Moxifloxin (Vigamox)
1 gtt in 3x daily for 7 days
Side effects: eye burning, stinging, irritation, itching, dryness, redness tearing, blurred vision
1st line for contact lens wearers due to high incidence of pseudomonas
Preg Cat C

Gonococcal (treat immediately)
Ceftriaxone (Rocephin)
1g single IM dose plus azithromycinin those who weigh 45 kg
< 45kg reduced dose ceftriaxone
Plus saline lavage of eye

Chlamydia: tx w/ systemic abx
Neonate: erythromycin taken PO for 14 days
Adults: single PO azithromycin dose
plus topical saline lavage of eye

Question 10

Dry Eye Syndrome

Keratoconjunctivitis

Answer 10

Common; bilateral disruption of tear film

Most affected > 40 years

More common in women

Causes: decreased tear production, excessive tear evaporation, abnormal production of mucus or lipids in tear duct

Symptoms: dryness, burning, sandy-gritty eye irritation that gets worse as day goes on, pain, redness, pulling sensation, pressure behind eye

Damage to eye surface increases discomfort and sensitivity to bright light

Both eyes affected

Tx: First line
Environmental adjustment: humidity
Artificial tears and lubricants

Second line
Cyclosporine (Restasis) - prevents T cell activation
1-2 gtt q 12hrs
Side effects: burning, stinging, redness, pain, itching, burning, blurred vision, foreign body sensation, eye discharge
Preg Cat C

Question 11

Glaucoma

Answer 11

Intraocular pressure -> optic neuropathy

Can permanently damage vision in affected areas of eye -> blindness if untreated

Question 12

Glaucoma

Closed angle

Answer 12

Appears suddenly, painful , visual loss can be quick

Discomfort causes pt to seek help before permanent damage occurs

Question 13

Glaucoma
Open angle
Chronic
Adult onset

Answer 13

Progress slower at a slower pace; pts do not notice vision loss until disease has progressed significantly

Leading cause of irreversible blindness

Progressive visual loss -> central field loss

Increase aqueous and/or decreased outflow -> increased intraocular pressure

Intraocular Pressure Measurement: best test to dx glaucoma
Acceptable IOP = 10-21
Glaucoma dx = IOP > 15
IOP > 40 = emergency referral

Question 14

Glaucoma
Treatment
Goal: decrease ocular pressure, pressure retinal fibers

Answer 14

Beta blockers: non-selective (decrease production of aqueous humor)
Tomolol (Cosopt)
Levonbunolol (Betagan)
Carteolol
1 gtt 2x daily
Side effects: transient eye irritation, burning, tearing, conjunctival hyperemia, edema
Systemic effects: HA, hypotension, bronchospasm
Preg Cat C

Beta blockers: selective
Betaxolol (Betopic)
1 gtt 2x daily
Side effects: blurred vision, itching, swelling, eye pain, dryness
Systemic effects rare: fatigue, insomnia, nausea, dizziness, lightheadedness, bradycardia, hypotension, cold extremities, SOB, wheezing, depression
Safe use NOT established during pregnancy

Prostaglandins: improve outflow of aqueous humor
Bimatoprost (Lumigan)
Latanoprost (Xalatan)
Travoprost (Travatan)
1 gtt 1x daily at BEDTIME
Side effects: blurred vision, eye redness, discomfort, itchiness, foreign body sensation, dry eyes, tearing, eyelid crusting, increase in eyelash number number/length/thickness, darkens eyelashes and lids, eyelid changes, increased light sensitivity
Preg Cat C

Carbonic Anhydrase Inhibitors: inhibit carbonic anhydrase -> decreased aqueous fluid formation
Brinzolamide (Azopt)
Dorzolamide (Trust)
1 gtt 3x daily
Side effects: ocular burning, stinging, discomfort, bitter taste in mouth
Preg Cat C

Adrenergic Agonist: decrease norepi release from alpha receptors -> decrease aqueous humor
Apraclonidine (Lopidine)
Brimonidine (Alphaga)
1 gtt Q8h
Side effects: dry eyes, red eyes, eye irritation, HA, blurred vision, foreign body sensation, drowsiness.
Less common: corneal staining, increased sensitivity to light, eyelid redness, eye pain, tearing, eyelid swelling, low BP
Pre Gat B

Cholinergic blocking agents: increase aqueous outflow
Pilocarpine (Akarpine, isopto, pilocar)
1-2 gtt 3-4x/day
Side effects: transient stinging, burning, ciliary spasm, conjunctival vascular congestion, temporal/supraorbital HA, lacrimation, induced myopia
Systemic reactions: HTN, tachycardia, bronchiolar spasm, pulmonary edema, salivation, sweating, n/v/d
Preg cat C

Question 15

Glaucoma
Treatment
Agent selection

Answer 15

First line:
prostaglandins -> beta blocker can be substituted if pt can’t afford prostaglandins

Second line:
Substitution or addition of beta blocker (if failure to decreased IOP)

Third line:
Addition of Carbonic Anhydrase Inhibitor or Brimonidine

Question 16

Corneal abrasion

Answer 16

Localized loss of epithelium
Most common eye injury

Symptoms: severe eye pain with photophobia with/out foreign body sensation preventing opening eye
reduced visual acuity
lacrimation
blepharospasm

Causes: direct trauma, foreign body, contact lens

Fluorescein dye uptake (give pt tissue to wipe excess)
Seidel’s sign: possible foreign body does not stain -> streaming dye after insertion
* Do penlight exam prior to fluorescein

Rx treatment:
relieve pain, reduce risk of bacterial infection, promote healing
Usually heal within 48 hrs
AVOID steroids (increase risk of infection)

Question 17

Corneal abrasion

Treatment

Answer 17

Cycloplegic therapy: paralyze ciliary muscle
Anticholinergics (cause pupillary dilation and paralysis of accommodation)
* Rapid action, but shorter duration than atropine
Maximal cycloplegia: 25-75 min after instillation
Accommodation recovery: 6-24 hrs

Homatropine (more cost effective)
Cyclopentolate
1-2 gtt before abx 
Side effects: burning, stinging, redness, eye irritation, temporary blurred vision
C/I: narrow angle glaucoma
Preg Cat B/C

*Consider if pt will have to work, drive, use heavy machinery bc blurred vision lasts several hours

Question 18

Corneal Abrasion
Abx Tx
Efficacy established when relief of pain, decreased inflammation, no infection

Answer 18

Antipseudomonal agents: used only for contact lens wearers
Gentamicin: most inexpensive
Can cause pseudomonas resistance

Aminoglycoside: (gram negative and positive)
1-2 gtt q4h for 7-10 days
Side effects: ocular burning, irritations, conjunctivitis
Preg Cat C

Tobramycin: used in place of gentamicin secondary to resistance
1-2 gtt q4h for 7-10 days
Side effects: localized ocular toxicity and hypersensitivity, lid itching, swelling, conjunctival erythema
Preg Cat B

Sulfonamides (inhibit bacterial synthesis)
Sulfacetamide
1-2 gtt into conjunctival sac q2-3 hrs for 7-10 days
Side effects: local irritation, stinging, burning
Preg Cat C

Question 19

Stye (Hordelolum)

Rx treatment not recommended

Answer 19

Acute infection of secretory glands of eyelid, abscess of eyelid

Cause: Staph aureus; obstructed orifices of oil glands in eyelid

• incomplete removal of eye makeup, use of outdates or infected cosmetics, poor eyelid hygiene, inflammatory diseases of eyelid, stress and hormonal changes

Resolve on their own, pt w/ underlying skin issue are more prone

Use warm compress -> stimulates drainage of gland
if still present -> drain w/ lancet

Moxfloxin (vigamox): fluorquinolone
1 gtt 3x daily for 7 days
Side effects: eye burning, stinging, irritation, itching, dryness, redness, tearing, blurred vision
Preg Cat C

Question 20

Otitis Media

Answer 20

Eustachian tube blockage:
trapped air in middle ear is absorbed in surrounding tissues -> vacuum in middle ear

Effusion:
fluid from surrounding tissues is sucked into middle ear cavity -> middle ear effusion

Cause: Strep pna (most common), Haemophillus influenza, Moraxella, Staph aureus (resp inf)
Risk: cigarette smoke exposure, daycare, non-breast fed children, allergies

Common < 15 yo, most common <2yo

Symptoms: ear pain, trouble sleeping, cranky, pulling on ear, fever, irritability

Diagnosis:

• Acute onset of s/s
• Signs of middle ear effusion: bulging TM, limited or absent TM mobility, otorrhea, air-fluid level behind TM
• s/s of middle ear inflammation: TM erythema, pain, tugging ear

Tx: only when symptoms of infection present, bilateral presentation, or otorrhea
Observe unless: bilateral s/s, < 6 yo, otorrhea, severe/prolonged s/s, fever > 102.2F

Question 21

Otitis Media
Treatment
Start w/ amoxicillin to prevent resistance to Cephalosporins

Answer 21

First line - unless allergy PCNs or use within 30 days
Amoxicillin/clavulanate: well tolerated, tastes like bubblegum (can change flavor to
<88 lbs: 90mg/kg divide into 2 daily doses q 12 hrs
>88 lbs: 875mg q 12 hrs

Side effects: stomach pain, n/v, vaginal itching/discharge, HA, swollen or black or hair tongue

Preg Cat B

2nd line allergy to PCN
Cefuroxime (Ceftin)
Ceftriaxone (Rocephin)
Azithromycin (Zithromax)
Clindamycin
Bactrim

Question 22

Otitis Externa

Swimmers ear

Answer 22

Cellulitis of ear canal skin and subdermis
Occurs suddenly

Risk factors: eczema, seborrhea, excessive itching, trauma from cerumen removal, chronic otorrhea, immunocompromised (DM).

Causes: swimming, local trauma, hearing aids, high/humid temp
* Pseudomonas aeruginosa, Staph aureus, occasionally fungus

Wax + swelling -> conductive hearing loss

Symptoms: painful outer ear, itching, fullness, tenderness of tragus or pinna (pull on upper ear -> pain, erythematous ear canal

Question 23

Otitis Media

Treatment

Answer 23

First line
Fluoroquinolone gtt
Ciprofloxacin + dexamethasone (Ciprodex)
tx of bacteria and inflammation
Side effects: ear discomfort, itchiness, unusual taste
Preg Cat C

2nd line
Neomyxin/polymixin B + Hydrocortisone gtt
Adults: 4 gtt 3-4x daily for 10 days
Infants + children: 3 gtt 3-4x daily for 10 days
Side effects: skin sensitization
Preg Cat C

Question 24

Ruptured/perforated tympanic membrane

Answer 24

ALL DROPS CONTRAINDICATED

Question 25

Tobacco products

Answer 25

Traditional cigarettes
Chewable tobacco
Ground tobacco (snuff)
Dissolvable tobacco

e-cigarettes: do not contain tobacco, Deliver vaporized nicotine. Nicotine is the addictive component

Question 26

Cigarette smoking

Answer 26

Chronic, addictive condition

Causes: lung ca, coronary heart disease, COPD, cardiovascular disease, aortic aneurysm, cerebrovascular disease, peripheral arterial disease, osteoporosis, earlier onset of menopause, increased metabolism of certain medication (theophylline, Tylenol, caffeine)

Life expectancy 10 yrs shorter for smokers

Adverse health effects lessen w/ smoking cessation

Question 27

Nicotine

Answer 27

Binds with nicotinic receptors -> relaxation, decreased stress and anxiety, improves concentration

Ganglionic cholinergic receptor agonist

Effects: 
Central and peripheral NS stimulation and depression
Resp stimulation
Skeletal muscle relaxation
Epi release by adrenal medulla
Peripheral vasoconstriction
Increased BP, HR, CO, O2 consumption

Cessation (withdrawal)> depressed mood, irritability, difficulty concentrating, anxiety, increased appetite, insomnia, restlessness
s/s last days, weeks, or longer

Smokers weight 2.4 - 4.5 kg less than nonsmokers

Question 28

Patient discussion

Process to begin drug or non drug therapy

Answer 28

Ask about tobacco use and record at every visit

Strongly advise every tobacco user quit

Assess willingness to attempt to quit

Assist pt willing to make attempt to quit -> offer meds/provide referral

Arrange follow-up contact within 1st week after quit date

Question 29

Nicotine Replacement Therapy

Most common

Answer 29

Control nicotine level in bloodstream -> withdrawal does not occur

Therapy goal: maintain cessation of smoking, develop preventative strategies to avoid relapse

No exposure to carcinogens and toxins in cigarette smoke

• Establish quit date with pt and add behavioral assistance program
• nonpharmalogical tx alone: low success rate

Question 30

Smoking cessation
Treatment
First line

Answer 30

First line
Bupropion (Wellbutrin)
SR 150mg/d for days; 150mg 2x daily for 7-12 weeks
Start while pt smoking
Taper dose not required
Side effects: dry mouth, insomnia/nervousness, difficulty concentrating, rash, constipation, sz
In addition to counseling during and after therapy
Ok in combo w/ depression
C/I: MAOI use -> wellbutrin toxicity

Nicotine gum: chew until pt feels tingling sensation; chew q15-30min
Side effects: sore throat, hiccups
C/I: dentures, jaw joint issue, dizziness

Nicotine inhaler: don’t use > 6mos

Nicotine nasal spray: no more than 5 sprays/hr; cause nasal irritation, HA, sore throat

Nicotine patch: 16-24h/d

Nicotine lozenge:dissolve for 20-30min; don’t swallow or chew lozenge
Side effects: hiccups, dry mouth, sore mouth
C/I: current use of other nicotine products

Varenicline (Chantix)
blocks nicotine binding, blocks acetylcholine receptor
0.5mg 1x daily for 1-3 days; 0.5mg 2x daily for 4-7d; 1mg 2x on day 8
Start 1 week before pt set quit date
Side effects: nausea, constipation, abnormal dreams, HA, difficulty concentrating, somnolence, visual disturbance
don’t use in current psych illness; cause suicidal ideation

Question 31

Smoking cessation
Treatment
Second line
Not FDA Approved

Answer 31

Clonidine
Reduce withdrawal symptoms in people addicted to narcotics or alcohol
3-7 day before quit date
Therapy: 3-10 weeks
When stopping: taper over several days
Side effects: dry mouth, drowsiness, dizziness, sedation
C/I: DM (hypoglycemia), rebound HTN

Nortriptyline
25mg/d -> titrate to 75 - 100mg/d
Duration: 12-24 weeks
Side effects: sedation, dry mouth
C/I: risk of arrhythmia

Question 32

Smoking cessation
Pregnancy
Breast feeding

Answer 32

Pregnancy
Nicotine replacement therapy can harm fetus
No meds intervention proven to increase long term cessation in pregnant women
* behavioral therapy reminded; med NOT recommended
Nicotine gum + lozenge: preg cat C
Nicotine patches, nasal spray, inhaler: preg cat D
Bupropion + Varenicline: preg cat C

Breast Feeding
No Nicotine replacement therapy evaluated for breast feeding, unknown if excreted in milk
Only consider if benefit of mother outweighs benefit of infant
Varenicline + Bupropion: AVOID

Question 33

Obesity

Answer 33

Causes: overall body energy stores and energy balance
Genetic
Environmental
Psychological
Hypothyroidism, Cushings, depression, antidepressants, steroids

Dx: BMI + waist circumference
BMI
< 18.5 = underweight
18.5 - <25 = normal
25 - < 30 = overweight
30 - < 35 = class 1 obese
35 - < 40 = class 2 obese
> 40 = class 3 obese (morbid, extreme, severe obesity)

Waist circumference > 40 in (102 cm) in men; 35 in (88 cm) women = increased health risk in BMI 25- 34.9
No need to measure > 35

Question 34

Weight loss
Treatment
Goals

Answer 34

Reduce body weight; maintain lower body weight long term

Medications DO NOT change underlying physiology of weight regulation

Meds only approved for short term use
* determine underlying cause of obesity and reduce caloric intake or weight loss will not occur

Reduce caloric intake by at least 500kcal/d (1200-1500 for women and 1500-1800 for men)
Increase physical activity: aerobic activity 150min/wk (30min/d)
Behavioral therapy: self monitoring food intake, physical activity, weight

Behavioral interventions:
5-10% weight reduction in 1st 6 mos

Sustained weight loss of 3-5%:
Decreased hgn A1C, risk of DM, lowers triglycerides, HTN, cholesterol, decreased BG, decreased need for meds for chronic diseases related to weight

Question 35

Weight loss
Appetite Suppressants
In addition to lifestyle changes

Answer 35

Diethylpropion (Tenuate), Phentermine (Adipex)
Side effects: increased HR, increase BP, insomnia, tremor, HA
C/I: advanced atherosclerosis, uncontrolled HTN, pulmonary HTN, hyperthyroidism, glaucoma, < 16 yo
Schedule IV (potential for abuse)

Phendimetrazine (Bontril)
Side effects:increased HR, increase BP, insomnia, tremor, HA
C/I:advanced atherosclerosis, uncontrolled HTN, pulmonary HTN, hyperthyroidism, glaucoma, < 17 yo
Schedule III (potential for abuse)

Decrease appetite by stimulating hypothalamus to release noes
Caution in pt w/ hx of ETOH/substance abuse
Use caution < 16 yo
Adverse: urinary frequency, blurred vision, changes in libido, dry mouth, nausea

Monitor HR and BP

Question 36

Weight loss

In addition to lifestyle changes

Answer 36

Lipase InhibitorOrlistat (Xenical)
Side effects: oily spotting, flatus with discharge, fecal urgency, fatty/oily stool
C/I: Chronic malabsorption syndrome or cholestasis, safety not clear < 12 yo
May decrease absorption of fat soluble vitamins (A, D, E, K)
Caution: pt taking Coumadin bc it inhibits Vit K -> increased INR
Decreases amiodarone, levothyroxine, cyclosporine, some anticonvulsants

Serotonin 5-HT2c-receptor agonist
Lorcaserin (Belviq)
Side effects: HA, nausea, dry mouth, dizziness, fatigue, constipation, mood changes
C/I: SSRI, SNRI, MAOI, triptans, bupropion
Schedule IV: potential for abuse

Glucagon-like peptide-1 receptor agonist
Liraglutide (Saxenda)
Side effects: n/v/d, constipation, pancreatitis

Question 37

Weight loss

Combination drugs

Answer 37

Phentermine/topiramate
Side effects: increased HR, insomnia, dry mouth, constipation, paresthesia, dizziness, altered taste
C/I: MAOI, hyperthyroidism, glaucoma
Schedule IV: potential for abuse

Naltrexone/bupropion (Contrave)
Side effect: increased HR, increased BP, nausea, constipation, HA, vomiting, dizziness
C/I: MAOI, uncontrolled HTN, sz disorder, bulimia, anorexia, drug/ETOH withdrawal, pregnancy
* Boxed warning: suicidal ideation and serious neuropsychological events

Teratogenic effects
Stimulate hypothalamus to release norepi to feel full. MAOI also stimulate release of norepi -> potential for hypertensive crisis

Question 38

Weight loss

Special considerations

Answer 38

DM: weight loss may cause hypoglycemia

Smokers: smoking cessation -> weight gain. Higher focus on lifestyle changes to ensure pt abstains from smoking

Question 39

Active immunization

Answer 39

Administration of all or part of microorganism or modified organism to evoke immune response that mimics response of body to natural infection

Poses little to no risk to recipient

Limited protection: need booster -> Tetanus, MMR

Lifetime protection: no booster needed

Stimulate immune system to create plasma cells

Plasma cells ready to make specific antibodies

Immunity appears AFTER exposure

Can be natural or deliberate

Question 40

Passive immunization

Answer 40

For people already exposed or have the potential to be exposed to infectious agent

Antibodies produced by other animals injected into bloodstream

Short term immunity - body eventually destroys them

Administration of preformed antibody when pt has congenitally acquired defect or immunodeficiency
Infection results in high risk complications
Time does not permit adequate protection by active immunity -> immunizations against rabies and Hep B)

Used therapeutically during active disease to suppress effects of toxin or inflammatory response

Can be natural or deliberate
Natural: mother to fetus or breastmilk
Deliberate: vaccine (tropical diseases, rabies)

Question 41

Vaccines
Adverse events
C/i

Answer 41

Adverse Events
Common: fever, local irritation; usually mild to moderate

• serious side effect/adverse reaction does not prove causation by vaccine

Reporting adverse events
Vaccine Adverse Events Reporting System (VAERS)
Type of vaccine, lot, site, route, manufacturer

C/I
acute febrile illness, allergy to vaccine component, hx of hypersensitivity/anaphylactic reaction to vaccine constituents

Question 42

Vaccine

influenza

Answer 42

Everyone >6 mos receive vaccine
6 mos - 8 yo: 2 doses
> 8yo: 1 dose/season

~2 weeks for protection develop after vaccination

Influenza vaccine does not cause the flu

Ok to give with other vaccines

Recommended to receive vaccine by the end of October

Question 43

Vaccine

Tetanus

Answer 43

S/S of tetanus
jaw cramping
sudden, involuntary muscle tightening (spasms)
painful muscle stiffness all over body
trouble swallowing
jerking/staring (seizures)
HA
fever, sweating
changes in BP and HR

Vaccine: tetanus toxoid (TT)
inactive vaccine used to prevent tetanus
during childhood: 5 doses
adolescence: 6th dose
after 3 doses, almost everyone mostly immune
additional doses q 10 yrs to maintain immunity
booster w/in 48hrs of injury
high risk injuries and not fully immunized: tetanus antitoxin
vaccine: safe for pregnancy & HIV

DTap: given to babies and young children.
Protects against diphtheria, tetanus, pertussis

DT: for babies and young children with allergy to pertussis

Tdap: booster given to older children and adults. Protects against diphtheria, tetanus, pertussis

Td: booster for older children and adults that protects against diphtheria and pertussis