Summary University of Alabama NUR 521(NUR521); Pharm Exam 3 FINAL PROTOTYPE ONLY_Complete Latest 2025/26.

1. Measles, Mumps, and Rubella Virus Vaccine (MMR)
 Recommendations
o Combo of 3 live virus vaccine preferred over separate vaccines
 Preparations
o Live virus
o MMR and MMRV (Measles, mumps, and rubella, and varicella virus vaccine)
 Efficacy
o 97% effective after a single dose within 2-6 weeks
 Adverse Effects
o Mild: Local reactions; rash; fever; swollen glands in cheeks and neck and under the jaw;
pain, stiffness, and swelling in joints
o Severe: Transient thrombocytopenia and anaphylaxis
 Precautions
o Thrombocytopenia
o Thrombocytopenia-purpura (TTP)
 Contraindications
o Pregnancy
o Severe immunodeficiency (Ex: HIV/ autoimmune)
o Anaphylactic reaction to gelatin, eggs or neomycin “KNOW THIS”
 Additional Information
o Fever up to 103°F is NOT considered a serious effect


2. Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine (DTaP)
 Preparations
 Children
o DTaP (routine)
o DT for children <7 yr that should not get pertussis vax *** “NEED TO KNOW”
 Adolescents and Adults
o Tdap (Boostrix) - booster for DTap
o Td (Adacel) - booster for tet/dip but not pertussis
 DTap can be given to kids w/ mild febrile illness (URI w/ or w/out low grade fever)
 For kids w/ mod-severe febrile illness, postpone until illness has resolved
 Efficacy
 DTaP reduces risk of disease by 80-90%
 Protection begins after the third dose and persists 4 to 6 years (against pertussis) and 10
years (against diphtheria and tetanus).
 Adverse Effects
o Mild- moderate: Local reactions, fever, fretfulness, drowsiness, anorexia, persistent
crying
o Severe: Acute encephalopathy, convulsions, shock-like state

,  Precautions
o A shock like state
o Mild fever is NOT contraindicated for administration
o Fever (105°F or higher) occurring within 48 hours of vaccination and not attributable to
another identifiable cause
o Persistent, inconsolable crying lasting 3 or more hours and occurring within 48 hours of
vaccination
o Seizures (with or without fever) occurring within 3 days of vaccination
 Contraindications
o Anaphylactic reaction
o Encephalopathy
o Moderate or severe febrile illness
o NOT a contraindication: children with mild febrile illness (e.g., upper respiratory
infection with or without low-grade fever)
 Additional Information
o Booster required every 10 years
o Tdap—tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine
o A booster shot with Tdap is currently recommended for all children 11 to 18 years old.
o Td—tetanus and diphtheria
o Boosters with Td are given every 10 years thereafter.
 Different Variations
o DTaP: routine vaccination against diphtheria, tetanus, and pertussis
o DT: for children younger than 7 years who should not get pertussis vaccine
o Tdap: booster in adolescents and adults to protect against all three diseases
o Td: booster for adolescents and adults to protect against tetanus and diphtheria, but
not pertussis


3. Poliovirus Vaccine (IPOL), inactivated (IPV)
 Preparations
o Inactivated polioviruses (IPV)
o Trade name is IPOL
 Efficacy
o Antibodies develop after 2 or more doses in nearly all cases
o Adverse Effects
o Mild: Local soreness
o Severe: None
 Precautions:
o Allergy to streptomycin or bacitracin
 Contraindications
o Anaphylactic reaction to streptomycin , neomycin or bacitracin (AVOID) “KNOW THIS”

,4. Haemophilus influenzae type b (Hib) conjugate vaccine
 Protects against Meningitis, Pneumonia, Epiglottitis, and Septicemia
 Recommendations
o Vaccines made with an outer member protein elicit a stronger response than those
made with the tetanus toxoid
 Preparations
o PedvaxHIB and Comvax (made w/ OMP isolated from N. meningitidis) – MORE
EFFECTIVE
o ActHIB and Hiberix (made w/ tet toxoid)
 Efficacy
o Decreases risk of disease by 88-98%
o Protection begins in 1 week after first dose of PedvaxHIB
o Protection begins 1 week after the fourth dose of ActHIB
 Adverse Effects
o Mild: Local reactions, fever, crying, diarrhea, vomiting
o Severe: None
 Additional Information
o The vaccines made with OMP (marketed as PedvaxHIB and Comvaxa and abbreviated
PRP-OMP) elicit a stronger immune response than the vaccines made with tetanus
toxoid, marketed as ActHIB and Hiberix.


5. Varicella Virus Vaccine
 Protects against chicken pox and shingles (herpes zoster)
 Recommendations
o Avoid close contact with susceptible high-risk individuals (Neonates, pregnant women,
and immunocompromised people)
 Preparations
o Live, attenuated vaccine “NEED TO KNOW”
o Varivax (just varicella itself)
o ProQuad (Varicella plus MMR)
 Efficacy
o 99% of patients have full protection
 Adverse Effects
o Mild: Local reactions, fever, mild varicella-like rash (local or generalized)
o Severe: None
 Precautions
o Avoid aspirin (ASA) and other salicylates for 6 weeks due to Reye syndrome (about
90% of Reye syndrome cases are associated w/ ASA use)
 Contraindications

, o Pregnancy
o Cancers such as leukemia and lymphoma
o Hypersensitivity to neomycin or gelatin “KNOW THIS”
o Immunocompromised or taking immunosuppressants
 Additional Information
Vaccinated patients should temporarily avoid close contact with susceptible, high-risk
individuals (e.g., neonates, pregnant women, immunocompromised people)




6. Hepatitis B Vaccine
 Preparations
 Contains Hep B surface antigen (HBsAg)
 Made from a viral component- not live virus
 Cannot cause disease
 Children: Recombivax
 Adults: Engerix-B
 Timing: series of 2, 3, or 4 shots (3 for kids at birth, 1-2 months, and 6-18 months)
 Efficacy
o 90% protected after third dose
o Appears to protect for 5-7 years
 Adverse Effects
o Mild: Local discomfort, fever
o Severe: None
 Contraindications
o PMH of anaphylaxis to HP vax
o Baker’s yeast allergy “KNOW THIS”
7. Hepatitis A Vaccine (HepA)
 Recommendations
o All children 12-23 months of age
o If traveling to places with high rates of hepatitis A, including Central or South America,
Mexico, the Caribbean islands, Africa, Asia, and southern or eastern Europe
o Communities with frequent outbreaks of Hepatitis A
o Men who have sex with men
o Illegal drug use
o Chronic liver disease
o People who receive clotting factor concentrates
o If work with nonhuman primates or work with Hepatitis A in research laboratories
o If expect contact with an international adoptee from a country in which Hepatitis A is
common