Interacting drugs - summary

 Inflenza virus vacine + 

 Phenytoin although influenza vaccination reportedly inhibits the clearance of thes agent, further Theophylline incr studies have consistently failed to show ant adverse effects of influenza vaccination Warfarin incr among patients taking these drugs

Side effects of inflenza vaccine are generaly inconsequential in adults and occur at low frequency. Severe reactions are uncommon inadults and disabling effects are exceedingly rare.

Local- soreness at injection site for upto 1 to 2 days ( < 33% most frequent)

Systemic- fever, malaise, myalgia and other symptoms of toxicity although infrequent occur more often in children and others who have has no exposure to influenza virus antigen.

These reactions which begin 1 to 2 days are attributed to the influenza antigens (even though they are inactivated and continue most of the systemic side effects. Immediate presumbly allergic responses such as flare and wheal or various respiratory symptoms (extremely rare)

The use of products prepared from the embryonic fluid of chicken eggs is contraindicated in persons with a history of allergy to eggs or egg products. The vaccine is also contraindicated in individuals hypersensitive to any of components of the vaccine. In persons suspected of having allergic condition, precede immunization procedures with ascarth test or an intradermal injection ( 0.05 to 0.1ml ) of vaccine diluted 1:100 in sterile saline to determine possible sensitivity to the minute residual egg protein taht may be present in the vaccine. A positive skin reaction contraindiactes imunization with the vaccine. Defer immunization in the presence of acute respiratory disease or other infection or acute febrile illness.

Precautions

Concurrent vaccination- because children are accessible when pediatric vaccines are administered, it may be desirable to administer influenza vaccine simultaneously with routine pediatric vaccine, but in a different site.

Other neurologic disorteders- including encephalopathies have been temporarily associated with influenza vaccine

Febrile reaction- because of the possiblity of febrile reaction following immunization, weigh the value of immunizing patients with a history febrile convulsions.

Sero-conversion- vacination may not result in sero-conversion in all individuals.

Gullian Barre syndrome (GBS) - characterized by ascending paralysis, is usually seff-limited and reversible. Although most persons recover without residual weakness , approximately 5% of the cases are fatal. Advise persons who receive influenza vaccine of the possible risk as compared with the risk of influenza and its complications.

Sulfite sensitivity- sulfites may cause allergic-type reactions (eg. hives, itching, wheezing, anaphylaxis) in certain susceptible persons.

Warnings

Impaired immune response- Patients with impaired immune responsiveness, whether due to the use of immunosuppressive therapy (including irradition, corticosteroids, antimetabolites,alkylating agents and cytotoxic agents) agenetic defect, HIV infection or other causes, may have a reduced antibody response in active immunization process.

Imuninosuppression- immunosuppressed patients may experience a lower than expected antigenic response, altough in one study appropiate antibody responses occured in patients with HIV who received trivalent influenza vaccine.

Hypersensitivity- have epinephrine 1:1000 immediately available.

Pregnancy- influenza vaccine is considered safe at any stage of pregnancy

Children- Do not administer Fluvirin to children < 6 months. Safety and efficacy of other available in children < 6 months have not been established.

Indication-

Influenza

Dosage-

Do not inject IV. Give injections IM, preferably in the deltoid muscle for adults and older children, for infants older children, for infants and young children, the preferred site is the anterolateral aspect of the thigh.

Missed dose

1. If you miss a dose of this medicine, and remember it on the day it should be taken, take it as directed.

2. However, if you do not remember the mised dose until the next day,take the missed dose at that time and reschedule your every-other-day doses from then.

3. It is important that this vaccine be taken exactly as directed so that it can give you protection against Influenza

Pharmacology

Inoculation of antigens prepared from inactivated influenza virus stimulates the production of specific antibodies. Protection is afforded only against those strains from which the vaccine is prepared or against closely related strains.

Pregnancy

Influenza vaccine is considered safe at any stage of pregnancy

Children-

Do not administer Fluvirin to children < 6 months. Safety and efficacy of other available in children < 6 months have not been established.