POLIOMYELITIS VACCINE (INACTIVATED) 1 DOSE

Indications

• Constipation
• Irritable bowel syndrome
• Diverticular disease
• Prevention of straining during defecation post-surgery
• Management of stool consistency in patients with fecal incontinence

Dosage

Children: Refer to specific product guidelines for dosing information, as doses may vary depending on the formulation and the child's age and condition.

Adults: Refer to specific product guidelines for dosing information, as doses may vary depending on the formulation and the patient's condition.

Mechanism of action

Bulk-forming agents function by absorbing water in the intestinal lumen, which increases the stool volume. This mechanical effect stretches the intestinal walls, stimulating peristalsis and facilitating bowel movement. Additionally, the hydrated bulk can help to improve stool consistency and reduce the incidence of straining during defecation.

Pharmacodynamics

The pharmacodynamic effects of bulk-forming agents are primarily localized to the gastrointestinal tract. They increase stool bulk and moisture content, which can help to alleviate constipation. The onset of action typically occurs within 12 to 72 hours after ingestion, depending on the specific agent and individual patient factors.

Pharmacokinetics

Bulk-forming agents are not absorbed into the bloodstream and remain within the gastrointestinal tract. They exert their effects locally and are eliminated in the feces. The hydration of the bulk-forming agent occurs within the intestinal lumen, which helps to form a gel-like substance that enhances stool passage without systemic absorption.

Adverse effects

• Gastrointestinal discomfort
• Bloating
• Flatulence
• Diarrhea
• Nausea

Precautions

• Ensure adequate fluid intake to prevent gastrointestinal obstruction.
• Monitor for signs of allergic reactions in sensitive individuals.
• Use cautiously in patients with gastrointestinal disorders.

Pregnancy

Generally considered safe, but consult a healthcare provider for individual assessment.

Breast-feeding

Considered safe, but consult a healthcare provider for individual assessment.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Powder
• Capsules
• Tablets
• Granules

Indications

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

Dosage

Children: Refer to the BNF for Children for appropriate dosing schedules and recommendations for poliovirus vaccination in children.

Adults: Refer to specific guidelines for IPV and OPV administration in adults, as vaccination schedules may vary based on age and immunization history.

Mechanism of action

Poliovirus primarily infects the motor neurons of the spinal cord and brainstem, leading to cell lysis and apoptosis. The viral replication occurs in the cytoplasm of the host cells, resulting in the release of new virions. The immune response triggered by the infection can lead to paralysis due to damage to the motor neurons.

Pharmacodynamics

The pharmacodynamics of polio vaccines involve the induction of an immune response against the poliovirus. The IPV induces serum neutralizing antibodies, while the OPV induces both serum and mucosal immunity. This immune response prevents the establishment of infection and protects against the disease.

Pharmacokinetics

Poliovirus vaccines do not have a pharmacokinetic profile in the traditional sense, as they are biological products. However, the IPV is administered intramuscularly, leading to systemic absorption and subsequent immunogenicity. The OPV is administered orally, leading to replication in the gastrointestinal tract and inducing both humoral and cellular immunity.

Contra-indications

• Severe allergic reaction to polio vaccine components
• Immunocompromised state (inactivated vaccine preferred)

Adverse effects

• Injection site reactions (pain, swelling, redness)
• Fever
• Fatigue
• Gastrointestinal disturbances (nausea, vomiting)
• Rarely, vaccine-derived paralytic poliomyelitis

Interactions

• Live vaccines may be affected by immunosuppressive therapies
• Concurrent administration with other vaccines is generally safe but consult vaccination guidelines

Precautions

• History of allergic reactions
• Patients with a history of Guillain-Barré syndrome
• Caution in patients with neurological disorders

Pregnancy

Polio vaccination is recommended during pregnancy if the woman is at risk of exposure, as the benefits outweigh potential risks.

Breast-feeding

Polio vaccine can be administered to breastfeeding mothers without risk to the infant.

Storage

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

Formulations

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

Indications

• Influenza prevention
• Diphtheria prevention
• Tetanus prevention
• Pertussis prevention

Dosage

Children: Refer to specific vaccine guidelines for paediatric dosing, as it varies by vaccine type and indication.

Adults: Refer to specific vaccine guidelines for adult dosing, as it varies by vaccine type and indication.

Mechanism of action

Trivalent vaccines function by introducing inactivated or attenuated forms of three different strains of a pathogen into the body, stimulating an immune response. This process activates B-cells to produce antibodies specific to the strains present in the vaccine. The immune system then remembers these strains, enabling a quicker and more effective response upon future exposure.

Pharmacodynamics

The pharmacodynamics of trivalent vaccines involve the induction of both humoral and cellular immunity. Upon vaccination, the immune system generates antibodies against the three strains, leading to neutralization of the pathogens. Additionally, T-helper cells are activated, promoting the proliferation of B-cells and the formation of memory cells, which provide long-term immunity.

Pharmacokinetics

Trivalent vaccines have a unique pharmacokinetic profile as they are not absorbed or distributed like traditional pharmacological agents. Instead, they are administered via injection, leading to localized immune activation. The onset of immune response typically occurs within two weeks post-vaccination, with peak antibody levels reached within one to two months. The duration of immunity can vary, requiring booster doses for sustained protection.

Adverse effects

• Injection site reactions
• Fever
• Malaise
• Fatigue
• Headache
• Myalgia
• Nausea

Precautions

• Use with caution in individuals with a history of allergic reactions to vaccine components
• Monitor for allergic reactions post-vaccination
• Consider underlying conditions that may affect immune response

Pregnancy

Generally considered safe, but consult healthcare provider for individual assessment.

Breast-feeding

Typically safe, but consult healthcare provider for individual assessment.

Storage

Store in a refrigerator at 2-8 degrees Celsius, do not freeze.

Formulations

• Trivalent inactivated influenza vaccine
• Trivalent live attenuated influenza vaccine