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Pharm I - Eye > Immunization > Flashcards

Immunization Flashcards

1
Q

What is immunization?

A

renders a person protected from an infectious disease

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2
Q

how does immunity happen naturally? how does it work?

A

exposure to the disease once, giving the immune system a memory of the disease

on second exposure, the adaptive immune system elicits a faster, stronger rxn

don’t become clinically ill

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3
Q

What are the two ways to provide immunity?

A
  • passively

- actively

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4
Q

What is passive immunity?

A

the transfer of active humoral immunity (ready made Ab) from one person to another

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5
Q

what is an example of passive immunity involving infants?

A

maternal Ab transferred to fetus through placenta and breast feeding

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6
Q

How can passive immunity be induced artificially?

A

with high levels of humor (or horse) Ab (IgG)w specific for a pathogen or toxin transferred to non-immune individuals

can be used to counteract the effects of a toxin

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7
Q

when are 2 times passive immunity is used?

A
  1. when there is a high risk of infection and insufficient time for the body to develop it’s own immune response
  2. to reduce symptoms of ongoing or immunosuppressive disease
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8
Q

what are the benefits of passive immunity?

A
  • faster than active

- protects during incubation period

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9
Q

what are the cons of passive immunity?

A
  • short term solution
  • can get disease after IgG gone
  • not as effective as active
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10
Q

How is disease specific IgG created?

A

prepared by exposing humans or animals to the disease and than harvesting the Ab they make in response to disease

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11
Q

why is human IgG preferred to animal IgG?

A
  • less rxns

- lasts longer (3 wks)

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12
Q

If you are using animal IgG what do you need to do before administering the dose?

A

test for hypersensitivity

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13
Q

what animal causes the least amount of allergic rxns with passive immunizations?

A

rodents/mice

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14
Q

What diseases do we have IgGs available for? Human (7) and horse (3).

A 
Human: 
- Hep A
- Hep B
- Measles
- Rabies
- Rubella
- Varicella
- Tetanus 
Horse:
- botulism
- snake bite
- black widow
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15
Q

What is active immunization?

A

introduction of immunity after exposure to an antigen

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16
Q

How is active immunity achieved?

A

Through vaccines; Ab created by the recipient in response to vaccine and may be stored permanently

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17
Q

How are active immunizations delivered?

A

series of injections over time

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18
Q

T/F: everyone who receives a vaccine for the chicken pox will be immune?

A

F; not everyone who receives a vaccination is immune.

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19
Q

What do vaccines usually contain?

A

agents that resemble disease-causing microorganisms

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20
Q

What are vaccines usually made from (4 materials)?

A
  • weakened microbes
  • killed microbes
  • microbe toxins
  • microbe surface proteins
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21
Q

What are the 3 different types of vaccines available today?

A
  • live attenuated
  • killed, inactivated
  • toxoids
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22
Q

What materials do live attenuated vaccines?

A
  • weakened microbes
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23
Q

How do live attenuated vaccines work?

A

weakened microbes replicated after administration to induce an immune response

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24
Q

What type of materials do viral vaccines usually use?

A

live viruses that have been chemically modified to decrease its virulence

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25
Q

how does chemically modifying live viruses benefit administration of live attenuated vaccinations?

A

doesn’t cause serious disease in healthy immune systems

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26
Q

Benefits of live attenuated vaccines?

A
  • good response

- 1-2 doses for lifetime immunity

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27
Q

what live attenuated vaccine do we have to administer annually?

A

the flu vaccine

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28
Q

Who should not receive live attenuated vaccines?

A

Immunocompromised: pt that can’t tolerate even a mild form of the disease

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29
Q

What is the downside of live attenuated vaccines?

A
  1. can revert to more pathologic form and cause disease
  2. most contraindications
  3. pt can shed live virus after vaccine
  4. most S/E
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30
Q

List 5 types of live attenuated vaccines.

A
  • intranasal influenza
  • small pox (not since ‘72)
  • Measles, mumps, rubella (MMRII)
  • varicella vaccine
  • varicella-zoster vaccine
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31
Q

how are killed, inactivated vaccines made?

A

by inactivating, or killing, the virus during the process of making the vaccine

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32
Q

are killed, inactivated vaccines made from whole bacteria/viruses or fractional antigenic components?

A

both

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33
Q

what are fractional, killed, inactivated vaccines made from?

A

protein or polysaccharides

34
Q

what are the disadvantages of killed vaccines?

A
  • higher dose than live

- multiple doses needed to build & maintain immunity

35
Q

what are the advantages of killed vaccines?

A

can’t cause disease and are not contagious

36
Q

What are conjugate vaccines?

A

sugar (polysaccharides) + protein of bacterium

37
Q

what are examples of killed vaccines? (10)

A
  • Tetanus, diptheria (Td)
  • Tetanus, diptheria, acellular pertussis (Tdap)
  • HPV
  • influenza
  • pneumococcal
  • hep A
  • hep B
  • hep A/B
  • meningococcal
  • flu
38
Q

why are polysaccharides important for conjugate vaccines?

A

necessary to elicit t-cell response; help immune system develop response

39
Q

what are examples of conjugate vaccines?

A
  • Pneumovax 23 (pneumococcal conjugated)
  • many strains used
  • Prevnar (protein conjugated)
40
Q

why shouldn’t children

A
  • coating disguises Ag
  • hard to recognize Ag
  • won’t develop immune response to it
41
Q

what conjugated vaccine can you use with kids under 2 for pneumococcal immunity?

A

prevnar

42
Q

Compare prevnar to pneumovax.

A

prevnar

  • can use w. kids under two
  • fewer strands (13)
43
Q

What are toxoid vaccines?

A

prevent disease caused by bacteria that produce toxins

44
Q

how are toxoid vaccines created?

A

toxins of bacteria are weakened

45
Q

what metal helps to prolong absorption of toxoids?

A

aluminum; prolongs exposure to immune system and increases its response

46
Q

what are examples of toxoid vaccines?

A
  • tetanus

- diphtheria

47
Q

how are vaccines administered?

A
  • IM
  • SQ
  • PO
  • intradermally
  • intranasally
48
Q

what is seroconversion? why is it used?

A

development of Ab in the blood that are measured after vaccination to see if immune; not all vaccines are successful

49
Q

why isn’t seroconversion used sometimes?

A

not all vaccines produce Ab to measure

50
Q

how are vaccinations normally administered? why?

A

in a series; each one boosting memory and immune response

51
Q

T/F if you miss a dose during a scheduled vaccination series you are less immune.

A

F; just give next dose at next appointment.

52
Q

You should not give vaccinations early if you can avoid it. Why?

A

previous dose may not have had time to acquire memory, there by decreasing its efficiency

53
Q

why are some vaccines combine in one dose?

A

to decrease number of injections

54
Q

what are the S/E of vaccines?

A
  • inflammation at injection site
  • malaise
  • fever
  • chills
  • HA
  • myalgia
  • febrile illness
  • seizures
  • anaphylaxis
  • somnolence
55
Q

what s/e of live attenuated do the other vaccines not share?

A

possible development of mild case of disease vaccinating against

56
Q

what are the contraindications of vaccinations?

A
  • anaphylactic rxn
  • immunodeficiency
  • pregnancy
  • encephalopathy after Dtap
57
Q

what vaccines commonly cause anaphylaxis due to containing neomycin?

A
  • inactivated polio vaccine
  • MMR
  • varicella
58
Q

what vaccines contain egg protein?

A
  • MMR

- influenza

59
Q

what vaccines should be avoided with immunodeficient patients?

A

live attenuated vaccines:

  • PO polio vaccine
  • MMR
  • varicella
60
Q

What vaccines are especially avoided during pregnancy?

A

live attenuated vaccines

  • MMR
  • varicella
  • influenza
61
Q

What vaccines are allowed during pregnancy?

A
  • inactivated influenza
  • Tetanus-diphtheria (Td)
  • Tetanus-diphtheria-pertussus (Tdap)
62
Q

when should tetanus-diphtheria (Td) vaccine be administered during pregnancy?

A

if unimmunized or booster due

@ 0, 4, 6-9 months pregnant

63
Q

when should tetanus-diphtheria- pertussus (Tdap) vaccine be administered during pregnancy?

A

if unionized to pertussis

After 20 weeks gestation

64
Q

when should Dtap and Tdap be held from patients?

A

if they developed encephalopathy within 7 days after administration of previous dose

65
Q

What are some examples of when vaccinations are not contraindicated?

A
  • mild to moderate local rxns
  • mild acute illness
  • during Abx use
  • prematurity
  • family Hx of adverse rxn
  • diarrhea
  • breast feeding
66
Q

what is the national vaccine injury compensation act?

A

compensates individuals who undergo injury from vaccines

67
Q

what is a requirement of healthcare providers, under the national vaccine injury compensation act?

A

must report all events requiring medical attention within 30 days of a vaccination

only must describe injuries temporal relationship to vaccine

68
Q

When do you give passive immunization?

A
  • rapid response

- use when pt at risk for disease before normal vaccine would work

69
Q

What are commonly given passive vaccinations?

A
  • hep A
  • varicella
  • tetanus
  • rhogam
70
Q

what is rhogam? what does it do and prevent?

A

passive IGIV immunization given to Rh - mother

prevents Rh- mother from mounting an immune response to the Rh + child

prevents hemolysis in the new born

71
Q

when would you give a passive and active immunization?

A
  • Rabies (due to severity)
  • infant born to Hep B+ mom
  • Tetanus (if never finished original series)
72
Q

What should be done after passive immunization (IgG) is given?

A

F/U with vaccination because passive immunity is short term solution

73
Q

Research says giving active and passive immunity at the same time may not be a great idea… why?

A

potential for Ag in vaccine to bind to Ab in passive immunity, decreasing immune response

74
Q

T/F if you are giving a shot for active and passive immunity they should be done in the same location on the body.

A

F; give them at different parts of body

75
Q

Are infants born to mother’s with Hep B given a vaccine or IgG at birth?

A

both, they greatly reduce transmission

76
Q

How many vaccines make up the original series for tetanus prophylaxis?

A

4

77
Q

Pt presents with tetanus prone wound; their full vaccine series finished 15 years ago. How should you proceed?

A

Administed booster

78
Q

Pt presents with tetanus prone wound; their full vaccine series finished 3 years ago. How should you proceed?

A

No further action needed

79
Q

Pt presents with tetanus prone wound; the never finished their full vaccine series. How should you proceed?

A

Give complete series and immunoglobulin (active & passive)

Toxins are produced within 5 days and it takes

80
Q

Pt presents with clean wound; they can’t remember if they finished their tetanus series. How should you proceed?

A

give complete series

81
Q

Pt presents with clean wound; they finished their complete series of tetanus vaccinations 15 years ago. How should you proceed?

A

booster

Pharm I - Eye (5 decks)

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