SPEEDA VACCINE

Indications

• Primary immunodeficiency disorders
• Secondary immunodeficiency states
• Autoimmune diseases such as Guillain-Barré syndrome
• Certain infections including viral hepatitis
• Prevention of infections in immunocompromised patients

Dosage

Children: Refer to the BNF for Children for appropriate dosing information tailored to paediatric patients.

Adults: Refer to the BNF for specific dosing information as it varies based on the condition being treated.

Mechanism of action

Immunoglobulins work by binding to specific antigens on pathogens, marking them for destruction by other immune cells. This can involve neutralization of toxins, opsonization for phagocytosis, and activation of the complement system, leading to enhanced clearance of pathogens and modulation of immune responses.

Pharmacodynamics

The pharmacodynamics of immunoglobulins are characterized by their ability to modulate immune responses. They can enhance the activity of phagocytic cells, inhibit the proliferation of certain cells in the immune system, and alter the production of cytokines. The specific effects depend on the subclass of immunoglobulin and the nature of the disease being treated.

Pharmacokinetics

Immunoglobulins are typically administered intravenously or subcutaneously. They have a half-life that can vary widely depending on the specific product, ranging from several days to weeks. After administration, they distribute throughout the body, with a significant portion remaining in the vascular compartment. Metabolism occurs primarily through proteolytic degradation and clearance by the reticuloendothelial system.

Interactions

• antifungals, azoles + acalabrutinib: Severe (increases exposure)
• dronedarone + antipsychotics, second generation: Severe (increases exposure)
• mexiletine + antiarrhythmics: Severe (increases risk of torsade de pointes)
• mitotane + antiarrhythmics: Severe (decreases exposure)
• carbamazepine + antipsychotics, second generation: Severe (increases risk of myelosuppression)
• antiepileptics (carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone) + elexacaftor: Severe (decreases exposure)
• antiepileptics (carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone) + imatinib: Severe (decreases exposure)
• iron chelators + antiepileptics: Severe (decreases absorption)
• lumacaftor + antiepileptics: Severe (decreases exposure)
• antiepileptics (fosphenytoin, phenobarbital, phenytoin, primidone) + metyrapone: Severe (decreases effects)

Indications

• Rabies prevention in individuals at high risk of exposure
• Post-exposure prophylaxis following potential rabies exposure
• Vaccination for travelers to endemic regions

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations for pediatric patients.

Adults: Refer to the BNF for specific dosing guidelines, as it varies based on exposure risk and vaccination history.

Mechanism of action

The rabies vaccine works by stimulating the immune system to produce antibodies against the rabies virus. This is achieved through the introduction of inactivated or attenuated virus particles, which mimic the infection without causing the disease. The immune response generated helps to prevent the virus from causing illness upon subsequent exposure.

Pharmacodynamics

The rabies vaccine induces an adaptive immune response, leading to the production of neutralizing antibodies specific to the rabies virus. This immune memory protects against future infections. The vaccine is typically administered in a series of doses to ensure adequate immune response and long-term protection.

Pharmacokinetics

The pharmacokinetics of the rabies vaccine involve absorption at the injection site, followed by systemic distribution of the antigens. The onset of immunity generally occurs within two weeks after the initial vaccination, with peak antibody levels typically reached within one to two months. The duration of immunity can vary, necessitating booster doses in certain populations.

Interactions

• chloroquine+rabiesvaccine: Severe (decreases efficacy)

Pregnancy

Rabies vaccination is generally considered safe during pregnancy. However, the risks and benefits should be carefully evaluated.

Breast-feeding

Rabies vaccine is not known to cause any adverse effects in breastfeeding. However, consult with a healthcare provider for individual assessments.

Storage

Store the rabies vaccine in a refrigerator at 2-8 degrees Celsius. Do not freeze.

Indications

• Prevention of infectious diseases such as measles, mumps, rubella, hepatitis B, influenza, and human papillomavirus (HPV)
• Travel vaccinations for diseases endemic to certain regions
• Vaccination for at-risk populations, such as those with compromised immune systems or specific occupational exposures

Dosage

Children: Dosage varies by vaccine type and age; refer to the BNF for Children for specific dosing information.

Adults: Dosage varies by vaccine type and indication; refer to specific guidelines for each vaccine.

Mechanism of action

Vaccines work by mimicking an infection. They introduce a harmless component of a pathogen (antigen) to the immune system, prompting the body to produce an immune response. This includes the generation of antibodies and memory cells that provide long-term immunity. Upon subsequent exposure to the actual pathogen, the immune system is primed to respond more rapidly and effectively.

Pharmacodynamics

The pharmacodynamics of vaccines involves the activation of both humoral and cellular immunity. Vaccines stimulate B cells to produce antibodies against the pathogen, while T cells are activated to destroy infected cells. This dual response helps to establish immunological memory, which enables a faster and more robust response upon re-exposure to the pathogen.

Pharmacokinetics

Vaccines are administered via various routes, including intramuscular, subcutaneous, and oral. After administration, the antigens are presented to antigen-presenting cells, which activate T cells and stimulate B cell proliferation and differentiation. The half-life of vaccine-induced immunity varies depending on the type of vaccine, with some providing lifelong immunity and others requiring booster doses to maintain protection.

Contra-indications

• Severe allergic reaction (anaphylaxis) to a component of the vaccine
• Severe immunocompromised state for live attenuated vaccines

Adverse effects

• Local reactions at the injection site (pain, redness, swelling)
• Fever
• Fatigue
• Headache
• Muscle pain
• Joint pain
• Nausea

Interactions

• Immunosuppressive medications may reduce vaccine efficacy
• Concurrent administration of some vaccines may require spacing to optimize immune response

Precautions

• History of allergic reactions to vaccines or vaccine components
• Pregnancy (specific vaccines may be contraindicated)
• Moderate to severe acute illness with or without fever

Pregnancy

Consult healthcare provider. Some vaccines are contraindicated during pregnancy, while others are recommended.

Breast-feeding

Generally considered safe, but consult healthcare provider regarding specific vaccines.

Storage

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

Formulations

• Liquid suspension for injection
• Lyophilized powder for reconstitution