Week 8 - Final review Flashcards
Who should receive the Tdap vaccine?
- Children 7 years and older, adolescents and adults
- Pregnancy
- cancer
- HIV
- high dose glucocorticoids
True contraindication for DTaP or Tdap vaccine.
- Children with moderate or severe viral illness
- Anaphylactic reaction with previous vaccination or encephalopathy
Contraindications for Varicella vaccine
- Pregnancy
- Certain cancers
- Hypersensitivity to neomycin or gelatin
- Immunocompromised
Avoid aspirin and salacylates for 6 weeks afterwards
Contraindications for Hep B vaccine
Patients with prior anaphylactic reaction to vaccine or baker’s yeast
Examples of attenuated vaccines
- Hep A
- Hep B
- Influenza
Examples of live virus vaccines
- MMR
- Varicella
- Rotavirus
- Influenza (intranasal)
Examples of toxoid vaccines
- DTap
Examples of inactive viral antigen vaccines
Polio
what is natural immunity?
Immunity that you are born with, includes:
- Physical barriers
- Phagocytic cells
- Natural killer cells
What is Specific Acquired Immunity?
Occurs after exposure to a foreign substance, with each exposure the antigen immune response is more rapid and intense
What is cell mediated immunity?
Immune responses in which targets are attacked directly by immune system cells (T cell and macrophages).
Macrophages engulf and destroy cells and self-cells that are infected with the antigen are killed.
Includes delayed hypersensitivity reactions including:
- transplant rejection
- TB
What is humoral immunity?
Immune responses are antibody mediated (B lymphocytes and antibodies)
- antigen binds to B cell receptors
- antigen is lysed and presented at receptor sites
- T helper cells induce proliferation of B cells which then protect the body by:
1.) neutralization - antibody binds to antigen to prevent adherence to body cells
2.) opsonization - antibody promotes phagocytosis
3.) Complement activation - antibodies activate complement to enhance opsonization and lyse some cells
Antibodies also:
- Bind to large bacteria and act as a handle for phagocytes
- Bind to receptors on viruses and toxins so they can’t bind to body cells and harm us
- Provide immediate protection (think in the body fluids)
Define vaccine
Preparation containing whole or fractionated microorganisms. Administration causes the recipient’s immune system to manufacture antibodies directed against the microbe from which the vaccine was made.
What is the post exposure prophylaxis for a suspected rabies bite?
A dose of human rabies immune globulin (HRIG) and rabies vaccine given on the day of the rabies exposure, and then a dose of vaccine given again on days 3, 7, and 14.
What patient teaching is needed for post vaccine side effects?
- Vaccine information statements explain the benefits and risks (found on the CDC website)
- Educate on what the possible side effects are and when to seek help
- Tylenol/ibuprofen after vaccination (never before) to treat symptoms
Who can receive attenuated influenza vaccine (FluMist)?
Non-pregnant individuals between 2-49 years old
Pantoprazole
- indications
- common dosages
- directions for use
Indications
- Erosive esophagitis
- GERD
- Zollinger-Ellison syndrome
- Peptic(duodenal and gastric) ulcers
Common dosage
- 40mg twice per day (textbook)
Directions for use
- 40 mg PO once daily for up to 8 weeks (PDR)
For patients who have not healed after 8 weeks of treatment, an additional 8-week course may be considered.
Metronidazole
- indications
- common dosages
- directions for use
Indication
- H. pylori treatment
Common dosage
- 375mg capsules
- 250 & 500mg tablets
- As part of combination therapy
— 500mg BID
Directions for use
- Avoid alcohol when taking this drug, can lead to adverse reaction (disulfiram-like reaction)
Ondansetron
- indications
- common dosages
- directions for use
Indication
- Chemotherapy induced N&V
- Radiation induced N&V
- Prevention of PONV
Common dosages
- CINV – 0.15mg/kg IV
- Radiation – 8mg PO TID
- PONV – 16mg PO 1 hour prior to anesthesia (book)
—– (PDR) – 4mg IV q6
Directions for use
- Can prolong QT interval and cause dysrhythmias
—– Dizziness, faintness, SOB, palpitations, abnormal heart rhythm
Albuterol MDI
- indications
- common dosages
- directions for use
Indications
- Asthma exacerbation
- Bronchospasm related to COPD
- Prophylaxis of exercise induced asthma
Common dosage
- 90 mcg/inhalation
- 2 inhalations every 4-6 hours PRN
Directions for use
- If doing two inhalations, they should be separated by 1 minute
- Begin to inhale before activating the inhaler
- Demonstration of technique and written instructions
- Option for spacers to improve intake
DTap vaccine
Protects against diphtheria, tetanus and pertussis.
Given to babies and children under 7.
