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Immunization Therapeutics
Some of the therapeutics for immunizations
106
Pharmacology
Professional
03/15/2012

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Cards

Term
What are the four ways a person can develop immunity to disease?
Definition
1: Exposure to disease
2: Antibody transfer from mother to fetus
3: Administration of an immune immunoglobulin
4: Vaccines.
Term
If you're under two years old, what type of vaccine can you NOT get?
Definition
You can't use polysaccharide vaccines
Term
What is the mechanism of action for a conjugate vaccine?
Definition
They stimulate T cells which stimulate B cells.
Term
What is the mechanism of action for a polysaccharide vaccine?
Definition
They stimulate B cells directly without T cells.
Term
What is the difference in active and passive immunity?
Definition
Active means we produce the antibodies. Passive immunity is granted through another source, such as mother's milk, or from an animal antibody.
Term
What vaccines are in Pediarix?
Definition
Diptheria, tetanus, pertussis, HepB + Poliovirus
Term
What vaccines are in Pentacel?
Definition
Diptheria, tetus, pertussis, HiB, and Poliovirus.
Term
What are the live vaccines?
Definition
Herpes
Influenza
MMR
Rotavirus
Varicella
Term
Who should NOT get live vaccines?
Definition
Pregnant women and immunocompromised.
Term
Which vaccines are frozen?
Definition
Varicella and zoster vaccines
Term
How many vaccines can you get together on the same day?
Definition
As many as you like. Any combination
Term
You had a live vaccine today. How long must you wait to get another vaccine?
Definition
4 weeks.
Term
You had a live vaccine today. How long must you wait to get a PPD?
Definition
4-6 weeks.
Term
What is the schedule like for a multi-dose series of vaccines?
Definition
Generally, you will get one dose, wait 4 weeks, get the second dose, and then wait 4-5 months and get the final dose.
Term
I'm going on vacation and need to get my multi-dose vaccine early. Can I?
Definition
That depends. Are you within 4 days of the scheduled time? If so, yes. 5 days or more? You're out of luck.
Term
I had to wait 13 years between dose 1 and dose 2 of a vaccine. Do I have to restart?
Definition
Technically, no.
Term
Where should you administer a subcutaneous vaccine?
Definition
Thigh of an infant, upper arm of older children and adults
Term
Where should you administer an IM vaccine?
Definition
Upper thigh of infants and toddlers.
Older children and adults get it in the deltoid muscle.
Term
What vaccine goes in the buttocks?
Definition
None. You don't use the buttocks.
Term
Which vaccines are not given by injection? How are they given?
Definition
Rotavirus = oral
Influenza = nasal
Term
Who decides vaccine schedules?
Definition
Lots of people, but ACIP (Advicory Committee on Immunization Practices) is the main one.

CDC helps too.
Term
What vaccines are administered to children? (11)
How many are unique to children?
Definition
Hep B
Rotavirus **
Diptheria, tetanus, and pertussis (DTaP) **
Haemophilus influenzae Type B (HiB) **
Pneumococcal CONJUGATE (PCV) **
Inactivated polio virus (IPV)
Seasonal flu
Measles, mumps, and rubella (MMR)
Varicella
Hep A
Meningococcal (MPSV4)

4 are unique to kids: RV, DTaP, PCV, and HiB
Term
How many vaccines are given to older children (7-18 years old) (10)
How many are unique to older kids?
Definition
Tetanus, diptheria, and pertussis (TdaP) **
Human Pipillomavirus (HPV) **
Pnemuococcal polysaccharide (PPSV) **
Inactivated Poliovirus (IPV)
MMR
Varicella
HepA
HepB
Meningococcal (MCV4)

3 are unique: TdaP, HPV, and PPSV
Term
All adults should have what 6 vaccines?
Definition
Tetanus
MMR
Varicella
Influenza
diptheria,
Pertussis
Term
What vaccines are only indicated for older adults and when are they indicated?
Definition
Herpes Zoster is indicated for 50+, recommended 60+
Pneumococcal 23 is indicated for 65+
Term
If you're pregnant, what are the special vaccine rules for you?
Definition
Live vaccines are contraindicated.
NO Varicella
NO Zoster
NO MMR

You can give Tdap, and everyone gets TIV.
Term
You have COPD. What special vaccine requirements do you have?
Definition
Eh, none really. You get the same stuff everyone else does.
Term
You have Diabetes. What special vaccine requirements do you have?
Definition
For the most part, you get the same stuff everyone else does, but you also have an indication for HBV. Why? Iunno. You just do.
Term
How old must you be to get a live vaccine?
Definition
12 months old
Term
You're pregnant. Should you still get a seasonal flu vaccine?
Definition
Yup.
Term
If you're immunocompromised, what are the special requirements for vaccines?
Definition
You can't get live vaccines, and glucocorticoids suppress vaccine response
Term
What's the cutoff for steroids and how does that effect vaccines?
Definition
20mg/day or 2mg/kg daily for at least 2 weeks. (high-ish dose)
If you're on doses like that, you have to wait ONE MONTH.
Term
What are the absolute contraindications to a vaccine?
Definition
Anaphylaxis.
Term
You have an allergy to eggs. What vaccine should you avoid?
Definition
Influenza
Term
You have an allergy to Gelatin. What vaccines should you avoid?
Definition
Varicella, MMR, and Zostavax
Term
You have an allergic reaction to Neomycin. What vaccines should you avoid?
Definition
MMr, Polio, Varicella, and Zostavax
Term
You have an allergic reaction to Streptomycin. What vaccines should you avoid?
Definition
Polio
Term
You have an allergic reaction to Polymixin B. What vaccines should you avoid?
Definition
Polio
Term
Two vaccines have a contraindication to aspirin. What are they and why?
Definition
LAIV and Varicella. They cause a fever, so using aspirin might cause Reye's syndrome. No aspirin for you.
Term
My brother has an anaphalaxic reaction to the MMR vaccine. Am I contraindicated for that?
Definition
No.
Term
I'm breastfeeding. Can I still get vaccines?
Definition
Yes.
Term
I took a vaccine, and I got kinda sick afterwards. I shouldn't get any more vaccines, right?
Definition
No. You're an idiot if you think that. You still get vaccines like everyone else.
Term
When should you offer vaccines to patients?
Definition
Every time you see them.
Term
The diphtheria vaccine comes in multiple versions. What's the deal?
Definition
Dtap is for kids. It has MORE Diphtheria.
Tdap is for adults. It has less Diphtheria.
Term
How is a Diphtheria vaccine delivered?
Definition
IM
Term
You're getting a Tetanus shot today. How is the shot going to be delivered?
Definition
IM
Term
Does a tetanus shot have any rare side effects?
Definition
You sometimes get fever, aches, and neurologic disorders.
Term
What kind of vaccine is HiB?
Definition
It's a CONJUGATE vaccine.
Term
HiB comes in a few flavors. What's the difference?
Definition
Basically, the difference is the schedule. Pick one for Dose 1. Stick with it for the rest of that series. When you finish it and are going for your booster shot at age 12-15 months, you can use any of them.
Term
Are there any differences between the HiB vaccines?
Definition
Yes. PRP-OMP (PedvaxHIB) is given only two times. The rest are three times.
Term
How is the HiB vaccine delivered?
Definition
IM
Term
Unless you have an immunodifficiency, what's the cutoff for HiB vaccines?
Definition
59 months.
Term
What are the strains of HPV in gardasil? Which ones are high risk?
Definition
6,11,16,19

16 and 19 are high risk.
Term
Gardisil has a special minimum interval. What is it?
Definition
4 weeks between dose 1 and 2
12 weeks between 2 and 3.
Term
Who is Gardasil NOT approved for?
Definition
Anyone over 26
Pregnant women
Term
What type of vaccine is Measles?
Definition
Live-attenuated.
Term
How is the measles vaccine delivered?
Definition
SubQ
Term
Measles vaccine has a rare exception. What is it?
Definition
It's a live vaccine, so you don't normally give live vaccines to HIV patients. Except this one. They still get this one.
Term
Measles vaccine has a couple weird side effects that are rare. What are they?
Definition
Transient thrombocytopenia and eye pain.
Term
Mumps vaccine. What type is it?
Definition
Live attenuated.
Term
You're getting a vaccine for mumps. How are you going to receive it?
Definition
SubQ
Term
Measles had a weird thing about it. Mumps does too. What's the odd thing about mumps?
Definition
Don't get pregnant for 4 weeks after getting the vaccine.
Term
Mumps vaccine has three weird-ish ADRs. What are they?
Definition
Parotitis, Pruritus, and Purpura.

Ok. Pruritis isn't that odd. But otherwise, it's not PPP.
Term
Rubella has another name. What is it?
Definition
German Measles.
Term
Why do we worry about Rubella?
Definition
Congenital Rubella causes defects in the fetus.
Audotor, opthalmic cardiac, and neurologic deficits.
Oh, and it might cause miscarriage or stillbirth.
So... either you're severely impaired or dead. Fun.
Term
What kind of vaccine is Rubella?
Definition
Live attenuated
Term
Where is rubella vaccine administered?
Definition
IM
Term
Measles and mumps had weird things about them. Guess what? Rubella does too. What's the weird thing about THIS vaccine?
Definition
If you're a woman of childbearing age and you can't prove you're vaccinated, guess who has two thumbs and is about to get a new vaccine. You.
Term
Measles and mumps had weird little facts about them. Rubella does too. What is it?
Definition
If you're a woman of childbearing age and you can't prove you've gotten vaccinated for Rubella, guess who has two thumbs and is about to get a new vaccine? You!
Term
What's the relationship between Rubella vaccine and PPD?
Definition
It might suppress a POSITIVE result by up to six weeks. Kind of weird but true.
Term
After a rubella vaccine, you will excrete some of the virus? Are you contagious?
Definition
Nope!
Term
What are some weird, important, or rare side effects of the Rubella vaccine? Give me 3.
Definition
Rash is a big one. Also causes arthralgia, especially if it's in a postpubertal female. And it causes lympadenopathy.
Term
So when do you give Meningococcal vaccines?
Definition
Routinely given at age 11 or 12 and a booster shot when you're 16-18.
Term
What's a really important side effect of the meningocococal vaccine?
Definition
Guillain-Barre syndrome.
Term
Meningococcal vaccine comes in lots of flavors. What's the difference?
Definition
MPSV4 is a polysaccharide vaccine given to people over 55. It's administered SubQ

MCV4 is a conjugate vaccine given for college students and people 11-12 years old.

It's IM.

Remember. I'M in college. I get it IM.
Term
Pertussis vaccine. Who gets it?
Definition
Kids! They get 5 doses.
then again when 11-18
then again when over 65. Every six minutes, you get another dose.
Term
What's the precaution for Pertussis vaccine? There are 4.
Definition
You can have hypotonic hyporesponsive episode. A fever of 104.9 or higher, crying lasting more than 3 hours, and seizures.
Term
What are the important side effects of Pertussis vaccine? (3)
Definition
Seizures
Persistent crying spells
Encecphalopathy
Term
Every vaccine seems to have something weird about it. Pertussis has an exception too. What is it?
Definition
If you experience encephalopathy after the vaccine, that IS a contraindication. It's not just anaphalaxis.
Term
My kid had a seizure after a vaccine! What was the vaccine. Should they get it again?
Definition
That vaccine was Pertussis vaccine. Seizures are NOT a contraindication. They get another dose.
Term
Pneumococcal vaccine comes in two flavors. What are they? and what's the difference?
Definition
PCV13 and PCV23.
PCV13 has thirteen strains and is a conjugate vaccine. PCV23 has 23 strains and is a polysaccharide
Term
What's the dosing schedule like for Pneumococcal
Definition
Under 2 year, you give PCV13
PPSV23 is given to people older than 2.
If you're 65 or older and haven't had a pneumo vaccine in 5 years or more (i.e. you were a baby) you get another dose of the 23 valent variety to cover you for the 10 new ones in the newer 23 valent version.
Term
Who gets the Pneumococcal vaccine before they turn 65?
Definition
Anyone immunocompromised
Anyone with lung disease (COPD, Asthma, emphysema)
Heart disease
And Cochlear implants.
Term
What are 6 rare side effects of PPSV23?
Definition
Photophobia
Chills
Fever
Weakness
Myalgia
Headache
Term
How must Varicella vaccine be stored?
Definition
Out of light and frozen.
Term
You just reconstituted a varicella vaccine. Clock's ticking. How long do you have to give it before you've wasted that shot?
Definition
30 minutes.
Term
What's the weird thing about varicella vaccine?
Definition
After you get it, you can't use aspirin for 6 weeks due to Reye's Syndrome risk.
Term
What kind of vaccine is Zostavax? How is it administered?
Definition
It's a live vaccine given SQ.
Term
Who should get Zostavax?
Definition
It's indicated for over 50. It's recommended for 60+
Term
Zostavax is a bit different than most vaccines. What's it about?
Definition
Zostavax is to prevent shingles. Shingles is the result of reactivation of herpes zoster, which causes chicken pox. This is one of the rare cases where you give a vaccine to someone that has had the primary disease, sorta.
Term
What are three things that differentiate flu from the common cold?
Definition
High fever
Myalgia
Fatigue
Term
What month has the most flu cases?
Definition
Feb
Term
What goes into a flu shot?
Definition
Influenza comes in three varieties. A, B, and C.
C only infects animals.
So you get 2 strains of A
and 1 strain of B
Term
What is antigenic drift?
Definition
Small changes in surface antigens of flu viruses. This is common.
Term
What is antigenic shift?
Definition
This is a drastic change in the H (hemagglutinin) or N (neuraminadase) of the flu, usually by a jump from animal to human. These cause pandemics.
Term
Where does flu vaccine come from?
Definition
Hen's eggs.
Term
There's a new four valent version of the flu vaccine. How is it delivered?
Definition
Nasal spray
Term
Who should get a flu shot?
Definition
Everyone.
Term
What's the weird thing about kids and TIV vaccine?
Definition
If it's your first time getting TIV, you get TWO doses, 4 weeks apart.
Term
Who is TIV approved for?
Definition
Everyone over 6 months
Term
Who is LAIV approved for?
Definition
2-49 year old, and no chronic medical conditions.
Term
What are side effects for the two flu vaccines?
Definition
TIV has the standard ones and MIGHT cause Guillain-Barre.
LAIV causes runny nose, congestion, headache.
Term
How do you treat Influenza A?
Definition
You can use Amatadine or Rimantidine OR Tamiflu OR Relenza
Amantadine and Rimantadine ONLY work on Flu A, and resistance is common.
Term
What's special about Tamiflu?
Definition
It causes people to want to hurt themselves. Especially kids.
Term
You want to get LAIV, but you're taking antivirals. How long do you have to wait?
Definition
48 hours.
Term
Vaccines cause autism, right?
Definition
No. Thimersol does NOT cause autism. And it's been removed from pretty much all vaccines anyway.
*sigh*
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