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Pharmacology Exam 1 > Immunizations > Flashcards

Immunizations Flashcards

1
Q

Process by which the body makes it’s own antibodies

A

active immunity

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2
Q

Process by which antibodies are given through exposure

A

passive immunity

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3
Q

Which type of immunity provides longer immunity in general?

A

active immunity

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4
Q

Which type of immunity provides temporary protection (few weeks)?

A

passive immunity

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5
Q

Which type of immunity takes several weeks before protection is provided?

A

active immunity

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6
Q

Which type of vaccine induces an immune response more consistent with naturally occurring infections?

A

live vaccine

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7
Q

Which type of vaccine confers life long immunity in a single dose?

A

live vaccine

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8
Q

What are the live vaccines?

A

OPV, MMR, varicella, flu mist

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9
Q

What type of vaccine does not induce permanent immunity and requires additional doses (boosters)?

A

killed vaccine

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10
Q

What are some inactivated vaccines?

A

pertussis, IPV, hib, hep a/b, flu shot

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11
Q

This stimulates formation of antitoxin antibodies that will neutralize the toxin upon exposure before it can do damage.

A

toxoid

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12
Q

Tetanus and Diptheria are types of what?

A

toxoids

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13
Q

This is a sterile solution containing antibodies derived from human or equine sources.

A

immune sera

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14
Q

Immune sera confers what type of immunity?

A

passive immunity

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15
Q

Preferred IM site in infants

A

anterolateral aspect of thigh

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16
Q

Preferred IM site in larger toddlers, adolescents and adults

A

deltoid

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17
Q

Preferred depth for killed vaccines

A

Deep IM (not subq due to risks for inflammation, granuloma and necrosis)

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18
Q

Vaccine administration - multiple inactivated vaccines?

A

Yes, at different sites

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19
Q

Vaccine administration - inactivated and live concurrently?

A

yes (except cholera and yellow fever - 4 weeks)

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20
Q

Vaccine administration - concurrent live vaccines?

A

No (except MMR and OPV)

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21
Q

Vaccine administration - live vaccine and PPD?

A

No

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22
Q

Vaccine administration - live vaccine and immune sera?

A

No

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23
Q

Vaccine administration - inactivated vaccine and immune sera?

A

Yes

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24
Q

Immunization during pregnancy - Considerations

A

No live vaccines, killed vaccines in second trimester

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25
Immunization for preemies - Considerations
Same age, schedule and precautions as full term. Hep B may be delayed 2 months or >2000g.
26
Immunization for immunocompromised hosts - Considerations
Immune response is typically diminished. May need higher doses or more frequent boosters. Live vaccines can replicate easier.
27
Immunization if active malignant disease - Considerations
Killed vaccines and toxoids only. Live vaccine leukemic off chemo x 3 months.
28
Immunization if HIV - Considerations
Suboptimal response
29
Which vax are contraindicated if anaphylactic reaction to neomycin?
MMR, IPV, varicella
30
Which vax is contraindicated if anaphylactic reaction to streptomycin?
IPV
31
Which vax are contraindicated if anaphylactic reaction to eggs?
Flu, yellow fever
32
What are some factors that affect response to immunization?
viability of antigen (live vs killed), total dose, interval and number of doses, immunocompromise, route/site, length of needle (1 in)
33
What organisms does the TDAP/DTAP vax protect against?
corynebacterium diptheriae, clostridium tetani (the toxin not the bacteria) and bordetella pertussis
34
TDAP - live or killed?
killed
35
s/s diptheria
"bull neck" due to cervical lymphadenopathy
36
s/s pertussis
AKA whooping cough | inspiratory whoop after a series of paraoxysmal coughing
37
s/s c. tetani
tetanus from production of exotoxin that blocks glycine release from Renshaw cells in spinal cord typically hear about "lock jaw" but diaphragm/chest involovement is more significant
38
Who gets the DTAP?
<7
39
Who gets the TDAP?
>7
40
DTAP
4 doses + booster IM refrigerated
41
Contraindications to Pertussis vax
``` encephalopathy (within 7 days) seizure (within 3 days) persistent screaming 3+ hours or high pitched cry (within 48 hrs) Temp 104.9 + (within 48 hrs) shock like state (within 48 hrs) ```
42
Tx for diptheria exposure
``` immune sera (equine) For exposed household members, give Benzathine PCN. ```
43
Tx for tetanus exposure
tetanus immunoglobulin
44
Pertussis DOC
Macrolides: E-mycin or azithromycin
45
s/s measles
"Koplik spots" in the mouth (small white spots), conjunctivitis, coryza, cough x 7 days. Ultimately will get pneumo and encephalitis and die.
46
s/s mumps
parotitis (inflammation of cheeks), orchitis (inflammation of testes) and aseptic meningitis
47
MMR vaccine
SQ 2 doses, combo vax Live vax (no preg or immuno.) contains neomycin, made from chick eggs (allergy considerations)
48
Inactive Polio Virus (IPV)
inactivated preferred over OPV (live) 4 doses
49
Haemophilus Influenzae Type B Vax
Inactivated given in children <5 yrs old IM Various combinations (PedvaxHIB and Comvax - HIB + HepB), TriHIBit
50
HIB bacteria responsible for...
meningitis, epiglottitis, pneumo, sepsis, septic arthritis
51
Strep pneumoniae can cause...
OM, sinusitis, pneumonia
52
Pneumococcal Conjugate Vaccine (Prevnar 13)
``` inactivated SQ or IM children 6 wks-59 months 4 doses *we don't see much bacterial OM/sinusitis b/c of this vax ```
53
Pneumococcal Polysaccharide Vaccine (Pneumovax 23)
Inactivated SQ or IM and adults
54
Who should get Pneumovax 23?
1. immunocompetent adults >65, chronic disease, asplenia, environmental risk 2. immunocompromised >2 yrs 3. revaccination after 3-5 yrs for kids with nephrotic syndrome, asplenia, SC anemia
55
Flu shot
Inactivated | IM
56
Who should get a flu shot?
CV and lung disease, nursing home resident, HC worker, >65 yrs, metabolic disease, pregnant 2/3 trimester during flu season, HIV, household members of high risk groups
57
FluMist
live vaccine
58
Who should not get the FluMist?
egg allergy, Guillain-Barre syndrome, immunodeficiency, HIV, malignancy, leukemia, lymphoma, children taking ASA (Reye's syndrome), pregnant women Safety in asthmatics is unknow.
59
Cold vs Influenza
Cold: rare fever, productive cough, rare HA, feel ok, congested, sneezing, sore throat Flu - feel very sick, sudden onset, temp >101 x 3-4 days, nonproductive cough, seere HA, fatigue
60
Influenza - treatment
Tamiflu or Relenza
61
Meningococcal Vaccine
with the HIB vaccine | IM
62
Who should get the meningococcal vaccine?
1. Age 2-10 w/complement deficiencies, asplenia, high risk groups 2. 11-18 yrs, previously not vaccinated 3. unvaccinated college students in the dorm and anyone living in close quarters 4. Revaccinataion at 11-55 yrs old
63
Varicella Vaccine
live virus | SQ
64
Who should not get the varicella vaccine?
pregnant, immunocompromised, 3wks before or 5 months after an immune globulin
65
Hepatitis A vaccination
Killed virus | 2 doses
66
Who should get a Hepatitis A vaccination?
travelers to endemic areas, primate works, male homosexual, food handlers, HC workers
67
Hepatitis B vaccination
killed virus 3 doses Induces Anti-HBs
68
For infants of HBsAg + mothers...
Heb B and HBIG at birth | repeat vax at 1 and 6 months
69
Hepatitis Immune Globulin
post exposure within 24 hours or before 14 days after exposure Start vax series too
70
HPV vaccine (Gardasil)
HPV proteins 6, 11, 16, 18 | Help protect against cervical cancer, cervical adenocarcinoma, vag and vulvar neoplasia and genital warts
71
HPV vaccine (Cervarix)
provides less coverage HPV 16 and 18 only (warts) doesn't make sense to give
72
Rotarix or RotaTeq vaccine
live Rotarix (2 doses by 4th month) Rota Teq (3 doses by 32 wks) Only given to infants b/c they are at higher risk from dehydration/lyte imbalance from diarrhea
73
Vaccine related anaphylactic reaction - s/s
flusing, facial edema, urticaria, itching, swelling of mouth/throat, wheezing, difficulty breathing
74
Vaccine related anaphylactic reaction - treatment
1. maintain airway and provide O2 if needed 2. Epi 0.01 mg/kg up to 0.5 mg IM, repeat q 10-20 up to 3 doses 3. Benadryl and/or Prednisone
75
Can the flu vaccine cause the flu?
Flu shot - No (killed) | Remember: takes weeks for immunity
76
Can vaccines be mixed in same syringe?
No, only if manufactured that way
77
After a blood transfusion, which vax are CI and for how long?
MMR - 6 months (live) Varicella - 5 months (live) Inactivated - OK
78
Can you give two IM injections in same arm?
Yes, 1 inch apart and document location well in case of ADE.
79
Which vax cannot be given if the pt is taking steroids?
If 2mg/kg or >20mg of prednisone, considered "high dose" and immunocompromised so no live vax
80
How long do you have to wait until getting the MMR or Varicella after IG?
3-11 months (remember, T1/2 is long)
81
Can chemo patients can the flu shot?
Yes (killed)
82
Why do kids get the pneumococcal conjugate vaccine (prevnar) instead of pneumococcal polysaccharide vaccine (pneumovax)?
Because the polysaccharide vaccine is not effective in children.
83
What is the leading cause if vaccine preventable death?
Pneumonia
84
What are the normal and expected side effects if FluMust?
Cough, runny nose, sore throat
85
What is a main cause of pneumonia, OM, bacteremia and sinusitis?
Strep pneumonia
86
What does it mean if a vaccine is conjugated?
It contains the antibodies against which immunity is desired.
87
How does the immune system respond to encapsulated organisms?
Not very well. The immune system does not recognize them so an effective immune response is not triggered and thus infection can occur.
88
Which immune cell does the prevnar vaccine activate?
CD4+ helper T-lymphocyte

Pharmacology Exam 1 (19 decks)

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