NOVEL ORAL POLIOMYELITIS VACCINE TYPE 2 (NOPV2)

Indications

• Measles
• Mumps
• Rubella
• Yellow fever
• Varicella (chickenpox)
• Rotavirus

Dosage

Children: Refer to specific vaccine guidelines for paediatric dosing.

Adults: Refer to specific vaccine guidelines for adult dosing.

Mechanism of action

Attenuated vaccines work by mimicking a natural infection. The weakened pathogen replicates in the body, stimulating the immune system to produce a response against it, which includes the activation of T-cells and the production of antibodies. This prepares the immune system to recognize and fight off the pathogen if exposed in the future.

Pharmacodynamics

The pharmacodynamics of attenuated vaccines involve the interaction of the attenuated pathogen with the host's immune system. Upon administration, the vaccine induces both humoral (antibody-mediated) and cell-mediated immunity. This leads to the development of memory cells that ensure a faster and more effective response upon subsequent exposure to the actual pathogen.

Pharmacokinetics

Attenuated vaccines are generally administered via subcutaneous or intramuscular injection. The pharmacokinetics are characterized by the distribution of the vaccine components within the body, with the attenuated organisms replicating locally and inducing an immune response. The onset of immunity typically occurs within weeks, and the duration of immunity can vary depending on the specific vaccine.

Contra-indications

• Severe immunodeficiency
• Pregnant women (specific live attenuated vaccines)
• Severe allergic reactions to vaccine components

Adverse effects

• Injection site reactions (pain, swelling, redness)
• Low-grade fever
• Malaise
• Rash
• Rare neurological complications (e.g., Guillain-Barré syndrome)

Interactions

• Immunosuppressive agents (may reduce vaccine efficacy)
• Blood products (may interfere with immune response to vaccine)
• Other live vaccines (timing may affect immune response)

Precautions

• History of allergic reactions to previous vaccinations
• Presence of active infections
• Chronic illnesses that may affect immune response

Pregnancy

Live attenuated vaccines are generally contraindicated during pregnancy due to potential risks to the fetus.

Breast-feeding

Most live attenuated vaccines are considered safe during breastfeeding, but caution and consultation with a healthcare provider are advised.

Storage

Store in a refrigerator at 2-8°C. Do not freeze. Protect from light.

Formulations

• Injectable suspension
• Oral suspension
• Lyophilized powder for reconstitution

Dosage

Children: Refer to pharmacological literature for specific dosing guidelines based on the drug and condition being treated.

Adults: Refer to pharmacological literature for specific dosing guidelines based on the drug and condition being treated.

Mechanism of action

Cells perform their functions through complex biochemical processes including signal transduction, gene expression, and energy metabolism. These processes are regulated by various molecules such as enzymes, hormones, and signaling pathways that facilitate communication within and between cells.

Pharmacodynamics

Pharmacodynamics in the context of cells refers to how cells respond to various drugs or stimuli. This includes receptor activation, intracellular signaling cascades, and modifications of cellular behavior such as proliferation, differentiation, or apoptosis. The response can vary greatly depending on the cell type and the specific conditions.

Pharmacokinetics

Pharmacokinetics involves how substances are absorbed, distributed, metabolized, and excreted by cells. For drugs, this includes how they enter cells, their distribution within cellular compartments, metabolic conversion to active or inactive forms, and ultimate removal from the body. Each of these processes significantly influences the efficacy and safety of pharmacological interventions.

Pregnancy

Cell therapy and manipulation during pregnancy require caution. The effects on fetal development depend on the type of cells used and the intended application.

Breast-feeding

The implications of cell therapy during breastfeeding are not well studied, and caution is advised.

Storage

Cells should be stored in controlled environments, typically at low temperatures to maintain viability, such as liquid nitrogen for cryopreserved cells.

Indications

• Chronic Kidney Disease
• Acute Kidney Injury
• Hypertension
• Electrolyte Imbalance
• Urinary Tract Infections
• Nephrotic Syndrome
• Kidney Stones
• Diabetes Insipidus

Dosage

Children: Refer to specific pediatric dosing guidelines as it varies based on condition and renal function.

Adults: Refer to specific clinical guidelines for dosage as it varies based on condition and renal function.

Mechanism of action

The kidneys function by filtering blood through nephron units, which consist of glomeruli and tubules. In the glomerulus, blood is filtered, and essential substances are reabsorbed in the tubules. The nephron's loop of Henle and distal convoluted tubule fine-tune water and electrolyte reabsorption, influenced by hormones such as aldosterone and antidiuretic hormone (ADH). This process regulates blood volume and pressure, electrolyte levels, and acid-base balance.

Pharmacodynamics

The kidneys respond to various hormones and regulatory mechanisms to maintain homeostasis. For example, renin-angiotensin-aldosterone system activation leads to increased sodium reabsorption and potassium excretion, which raises blood pressure. Antidiuretic hormone promotes water reabsorption, affecting urine concentration and volume. Diuretics can alter these dynamics by inhibiting sodium reabsorption, leading to increased urine output.

Pharmacokinetics

The kidneys receive a large portion of cardiac output, approximately 20-25%, allowing for efficient filtration and excretion. Blood is filtered in the glomeruli, with a typical glomerular filtration rate of 90-120 mL/min in healthy adults. Substances are reabsorbed or secreted along the nephron, with renal clearance rates reflecting the kidneys' ability to eliminate drugs and metabolites from the body. Factors such as age, kidney function, and coexisting diseases can significantly affect pharmacokinetics.

Pregnancy

Consult a healthcare provider for advice regarding kidney health and any specific conditions during pregnancy.

Breast-feeding

Consult a healthcare provider for advice regarding kidney health and any specific conditions while breastfeeding.

Storage

Store in a cool, dry place. Keep away from direct sunlight and moisture.

Indications

• Measles
• Mumps
• Rubella
• Varicella (chickenpox)
• Yellow fever
• Rotavirus
• Intranasal influenza

Dosage

Children: Refer to the BNF for Children for specific dosing information based on age and vaccine type.

Adults: Refer to specific product guidelines for dosing information, as it can vary by vaccine type and brand.

Mechanism of action

Live vaccines work by introducing a weakened or attenuated form of a pathogen into the body. This stimulates the immune system to recognize and respond to the pathogen, leading to the production of antibodies and memory cells that provide long-term protection against future infections by the same pathogen.

Pharmacodynamics

The pharmacodynamics of live vaccines involve the activation of both humoral and cellular immunity. Following vaccination, the immune system generates a robust response, including the production of specific antibodies and the activation of T cells that can recognize and eliminate infected cells. This dual action helps establish long-term immunity.

Pharmacokinetics

The pharmacokinetics of live vaccines vary depending on the specific vaccine. Generally, the vaccine is administered via injection, allowing the live attenuated organisms to enter the bloodstream. The immune response typically begins within days and can last for years, depending on the vaccine. Live vaccines are usually stored under refrigeration to maintain their viability, and they should be administered within their expiration dates.

Interactions

• livevaccines + abrocitinib: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + baricitinib: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + filgotinib: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + dexrazoxane: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + iron chelators: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + ozanimod: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + ponesimod: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + siponimod: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + upadacitinib: Severe (increases risk of generalised infection (possibly life-threatening))
• livevaccines + diroximelfumarate: Moderate (increases risk of generalised infection (possibly life-threatening))

Dosage

Children: Refer to relevant pharmacological studies or veterinary guidelines for specific dosing.

Adults: Refer to relevant pharmacological studies or veterinary guidelines for specific dosing.

Pregnancy

There is insufficient data to establish the safety of monkey use during pregnancy.

Breast-feeding

There is insufficient data to establish the safety of monkey use during breastfeeding.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Prevention of poliomyelitis infection
• Vaccination in children and high-risk populations

Dosage

Children: Refer to the BNF for Children for specific dosages and recommendations for vaccination schedules.

Adults: Refer to specific vaccination guidelines for adults, as dosages may vary based on risk factors and prior vaccination history.

Mechanism of action

Poliovirus enters the body through the oral route, replicating in the oropharynx and gastrointestinal tract before spreading to the central nervous system via the bloodstream. Once inside the CNS, the virus selectively infects motor neurons in the anterior horn of the spinal cord, leading to cell lysis and resulting in muscle weakness or paralysis. The immune response to the virus contributes to inflammation and further neuronal damage.

Pharmacodynamics

The poliovirus's pathogenicity is primarily due to its ability to evade the host's immune response and its selective neurotropism. The destruction of motor neurons leads to flaccid paralysis, with recovery possible in some cases as the motor neurons may regenerate. The severity of the disease correlates with the extent of neuronal involvement, which can vary widely among individuals.

Pharmacokinetics

Poliovirus is an RNA virus that does not undergo traditional pharmacokinetic processes as it is not treated with drugs. Instead, the prevention of polio relies on vaccination strategies. The inactivated poliovirus vaccine (IPV) and the oral poliovirus vaccine (OPV) are used to induce immunity. After administration, the vaccines promote the development of antibodies against the virus without causing disease.

Contra-indications

• Hypersensitivity to the vaccine component
• Severe immunodeficiency
• Acute febrile illness

Adverse effects

• Pain at injection site
• Fever
• Fatigue
• Headache
• Nausea
• Allergic reactions

Interactions

• Immunosuppressive therapies may reduce vaccine efficacy
• Concomitant administration with other vaccines may affect immune response

Precautions

• Use with caution in individuals with moderate to severe acute illness
• Consider history of allergic reactions
• Monitor for signs of anaphylaxis after administration

Pregnancy

Poliomyelitis vaccination is generally considered safe during pregnancy, but consult a healthcare professional.

Breast-feeding

The vaccine is considered safe for breastfeeding mothers.

Storage

Store at 2 to 8 degrees Celsius. Do not freeze. Protect from light.

Formulations

• Inactivated poliovirus vaccine (IPV)
• Oral poliovirus vaccine (OPV)

Dosage

Children: Refer to the specific preparation’s guidelines for paediatric dosing information.

Adults: Refer to the specific preparation’s guidelines for dosing information.

Mechanism of action

The mechanism of action varies widely depending on the specific active ingredients within the prepared formulation. Generally, these mechanisms involve interactions with biological targets such as receptors, enzymes, or cellular processes to elicit a desired therapeutic effect.

Pharmacodynamics

Pharmacodynamics of prepared substances depend on their active components. They may exhibit actions ranging from agonistic or antagonistic effects on receptors, modulation of enzyme activity, or alteration of cellular signaling pathways. The specific dynamics will determine the onset, intensity, and duration of therapeutic effects.

Pharmacokinetics

Pharmacokinetics involves the absorption, distribution, metabolism, and excretion (ADME) of the drug. For prepared drugs, absorption can be influenced by the formulation type, with some forms being rapidly absorbed while others are designed for slow release. Distribution is often determined by the lipophilicity of the drug and its ability to cross biological membranes. Metabolism typically occurs in the liver, and excretion may happen through the kidneys or bile, depending on the drug's chemical properties.

Pregnancy

Safety in pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Caution is advised. The effects on a nursing infant are unknown; consider the importance of the drug to the mother.

Storage

Store in a cool, dry place away from light. Ensure the container is tightly closed.

Indications

• Influenza
• HIV/AIDS
• Hepatitis B and C
• Herpes simplex virus infections
• Cytomegalovirus infections
• COVID-19
• Respiratory syncytial virus infections

Dosage

Children: Refer to specific antiviral agents for dosing guidance.

Adults: Refer to specific antiviral agents for dosing guidance.

Mechanism of action

Viruses infect host cells by attaching to specific receptors on the cell surface. Once inside, they hijack the host cell's machinery to replicate their genetic material and produce viral proteins. New viral particles are assembled and released from the host cell, often destroying the cell in the process. The specific mechanism can vary depending on the virus type, including integration into the host genome in retroviruses or utilizing specific pathways for replication.

Pharmacodynamics

The pharmacodynamics of antiviral agents depend on the specific virus and the mechanism of action. Antiviral drugs may inhibit viral entry into host cells, block viral replication, or prevent the assembly of new virions. The effectiveness of antiviral therapy often relates to the stage of viral replication and the immune response of the host.

Pharmacokinetics

Pharmacokinetics of antiviral drugs varies widely based on the specific medication used. Generally, antiviral agents are absorbed through the gastrointestinal tract and distributed throughout the body. They may undergo hepatic metabolism and are often excreted through the kidneys. The half-life of these drugs can range from a few hours to several days, influencing dosing schedules.