FINAL EXAM: NR565/ NR 565
ADVANCED PHARMACOLOGY CARE OF
THE FUNDAMENTALS EXAM QUESTIONS
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Example of toxoid vaccine
tetanus and diphtheria (DTap)
Example of Inactive viral antigen vaccine
Poliovirus vaccine, inactivated (IPV, Salk vaccine) Hep A vaccine
Hep B vaccine
Influenza vaccine
Herd immunity (community)
, The resistance to an infectious organism because a large group of people is immune to the infectious
organism through immunization/vaccine. Herd or Community immunity is contingent on the likelihood
individuals are prone to the infection will encounter the infected person.
Active immunity
When the immune system produces antibodies in response to an antigen by the vaccine, or by the
infection itself. For example, if a person who has never had hepatitis B contracts hepatitis B and
recovers from it, that person becomes immune to hepatitis B because of the immune system's antibody
response to the hepatitis B virus
Passive immunity
The immunity that occurs naturally. This type of immunity is passed on when an antibody is produced in
another host. Passive immunity can be achieved naturally through the transfer of antibodies from a
mother to her fetus during pregnancy or through breast milk after birth.
What is a vaccine?
Preparation containing whole or fractioned microorganisms, which cause recipients immune system to
manufacture antibodies directed against the microbe
Patient teaching and assessments for post vaccine side effects
Local reactions: discomfort, swelling, erythema at injection siteFever is commonVery rare but severe
effects include anaphylaxis (e.g., in response to measles, mumps, and rubella virus vaccine); acute
encephalopathy (caused by diphtheria and tetanus toxoids and pertussis vaccine); and vaccine-
associated paralytic poliomyelitis (caused by oral poliovirus vaccine).immunocompromised children are
at special risk from live vaccines in the absence of an adequate immune response, the viruses or bacteria
in these normally safe vaccines are able to multiply in profusion, thereby causing serious infection.live
vaccines should generally be avoided in children who are severely immunosuppressed (congenital
immunodeficiency, human immunodeficiency virus (HIV) infection, leukemia, lymphoma, generalized
malignancy, and therapy with radiation, cytotoxic anticancer drugs, and high-dose glucocorticoids)
Post exposure prophylaxis for suspected rabies bite
1 mL dose IM on days 0,3,7,and 14
What to assess for if psyllium doesn't produce a bowel movement?
fecal impaction
What can be helpful to aid in diagnosis and treatment of IBS
a diary- Patients should keep a log to identify foods and stressors that trigger symptoms. Because large
meals stretch and stimulate the bowel, switching to smaller, more frequent meals may help. Increasing
dietary fluid and fiber may reduce constipation.
Who should receive the Tdap vaccine?
Immunocompromised, cancer, HIV, high-dose glucocorticoid, pregnancy
, True contraindication for DTaP or Tdap vaccine.
history of anaphylactic reaction or encephalopathy within 7 days of vaccine
Varicella contraindications
pregnancy, cancers like leukemia or lymphoma, hypersensitivity to neomycin or gelatin,
immunocompromised (HIV&AIDS)
Hepatitis B virus (HBV) vaccine
Hepatitis B vaccine (HepB) contains hepatitis B surface antigen (HBsAg). Because HepB is made from a
viral component, rather than from a live virus, it cannot cause disease.
Hepatitis B virus (HBV) vaccine contraindications
Prior anaphylactic reaction to the vaccine itself or baker's yeast.
Soreness at injection site and mild to moderate fever.
Example of Attenuated vaccine
MMR vaccine
Varicella vaccine, varicella zoster
Rotavirus,
Flumist
Who can receive attenuated influenza vaccine (FluMist)?
(Ages 2-49 years) FluMist should not be administered to persons with asthma or children aged <5 years
with recurrent wheezing ), non-pregnant, and not immunocompromised
Example of live virus vaccine
Measles, mumps, and rubella virus vaccine (MMR)Measles, mumps, and rubella, and varicella virus
vaccine (MMRV) Varicella virus vaccineInfluenza vaccine (live)Rotavirus vaccine
How to treat gastroparesis (which your stomach can't empty itself of food in a normal fashion.
Symptoms include heartburn, nausea, vomiting, and feeling full quickly when eating)
Prokinetic= Metoclopramide(Reglan)
First line for N/V due to gastroparesis, liver failure and unknown causes.
Black box warning associated with treatment Metoclopramide (Reglan)
Can cause Tardive Dyskinesia, risk increased with length of treatment. Should discontinue at 12 weeks or
if the patient develops movement disorder
Metronidazole - Patient teaching needed
