NR 566 wk 5 Study Guide

Zoster Vaccine o Pharmacodynamics o Shingles is a localized and painful cutaneous eruption caused by reactivation of VZV o Latent in neuronal cell bodies and when reactivated causes shingles o Zoster vaccine (Zostava ...

Zoster Vaccine o Pharmacodynamics o Shingles is a localized and painful cutaneous eruption caused by reactivation of VZV o Latent in neuronal cell bodies and when reactivated causes shingles o Zoster vaccine (Zostavax): live attenuated VZV o Reduces risk of shingles by 50% and 66% effective in preventing post herpetic neuralgia o Reduces severity of zoster o Approved for adults aged 50 years and older o Most effective in patients aged 60 to 69 and least effective in those over age 80 o Pharmacotherapeutics o Contraindicated: Hx of anaphylactic reaction to neomycin, gelatin, or vaccine components o Do not give to those with primary immunodeficiency states o Do not give to those with leukemia, lymphoma, CA of the bone marrow or lymphatic system or AIDS r/t development of disseminated disease o Do not take while actively receiving high dose corticosteroids (prednisone), wait a month after stopping o Not approved for women of childbearing age and should not be used in pregnancy o Do not give to those with active TB or acute illness, or with fever o ADRs o Injection site pain/tenderness, erythema, swelling, and pruritis; HA o Drug Interactions o Stop antiviral drugs (acyclovir, famciclovir, and valacyclovir) 24 hours before vaccine admin o Do not use antiviral for at least 14 days after vaccination o Can be given before, after, or at the same time as blood products or antibody containing products o Stop long term/high dose prednisone for 1 month before vaccination o Short term or low dose may be vaccinated o Methotrexate low doses, azathioprine, or 6 mercaptopurine for Tx of RA, psoriasis, polymyositis, sarcoidosis, or IBD may be vaccinated with zoster vaccine