McKenna's Pharmacology for Nursing, 2e

279

C H A P T E R 1 8  Vaccines and sera

Cell

Protein release

Invasion

Cell injury

Histamine release

Vaccines work here Memory cells

B cell

Hageman factor

Rubor Calour Tumour Dolour

Effector T cells

Helper T cells

Plasma cells

Suppressor T cells

Kinin activation

Antibody formation

Interleukins

Leucocyte activation Pyretic effect

Immune sera, antitoxins, antivenins work here

Antigen–antibody complex

Cell death Inflammatory response

Complement activation

Inflammatory reaction

FIGURE 18.3  Sites of action of biologicals.

TABLE 18.1

DRUGS IN FOCUS Vaccines

Drug name

Dosage/route

Usual indications

Bacterial vaccines BCG vaccine (generic)

0.1 mL intradermal

Prevention of tuberculosis

Coxiella burnetii vaccine (Q-vax) Haemophilus B conjugate vaccine (Hiberix) Neisseria meningitidis vaccine (Mencevax ACWY, Meningitec, Menomune)

0.5 mL SC

Prevention of Q fever

0.5 mL IM at 2, 4, 6 and 12 months

Active immunisation against Haemophilus influenzae type b Active immunisation against meningococcal meningitis groups A, C, W 135 , Y Active immunisation against Streptococcus pneunomiae disease

Adult and paediatric >2 years: 0.5 mL SC

pneumococcal vaccine (Pneumovax 23, Prevenar)

Pneumovax 23, Adult and paediatric >2 years: 0.5 mL SC or IM Prevenar, Paediatric 6 weeks–6 months: 0.5 mL IM at 2, 4, 6 months and 12–15 months Typherix, Typhim Vi: Adult and paediatric >2 years: 0.5 mL slow IM into deltoid at least 14 days prior to exposure Vivotif: Adult and paediatric >6 years: 1 capsule swallowed on days 1, 3 and 5. Booster every 3 years

Salmonella typhi vaccine (Typherix, Typhim Vi, Vivotif)

Active immunisation against typhoid fever

Continued on following page