Travelers medicine/vaccines

  1. CDC travel medicine book color
    yellow
  2. Diseases through food/water: Traveler's Diarrhea (TD) location
    • bacteria/e coli
    • Asia, the Middle East, Africa, Mexico, Central and South America
  3. Diseases through food/water: Traveler's Diarrhea (TD) prophylaxis
    OTC bismuth subsalicylate reduce incidence by 50% OR if indicated for high risk - DOC rifaximin
  4. Diseases through food/water: Traveler's Diarrhea (TD) treatment
    • hydration
    • acute diarrhea: loperamide (Imodium A-D) - antimotility - 4 mg, then 2 mg, max 16 mg/day, up to 2 days
    • Bismuth subsalicylate - antiscretory, anti-diarrheal *not as good as loperamide
    • Antibiotics: mod-severe TD, macrolides, quinolones, rifaximin, if severe with dysentry = azithromycin, other two w/o dysentry
  5. Diseases through food/water: Typhoid fever location
    • bacteria/Salmonella typhi
    • East and Southeast Asia, Africa, the Caribbean, and Central and South America
  6. Diseases through food/water: Typhoid fever vaccine
    • Vivotif: LIVE attenuated, ORAL, 6+ yo, 1 week prior, Q5 years
    • Typhim Vi: inactivated, IM, 2+ yo, 2 weeks prior, Q2 years
    • only 50-80% effective, so hand hygiene still
  7. Diseases through blood/bodily fluids: meningococcal meningitis vaccine
    • bacterial/N. meningitidis  - respiratory secretions
    • Meningitis belt of Africa (Dec-June - dry), required by Saudi Arabia annual Hajj and Umrah pilgrimages - sero ACWY (no need for B)
  8. Disease through insect bites: malaria location
    • parasite/transmitted by Anopheles mosquito
    • 4 species: P. vivax (most common), P. falciparum (most deadly), P. ovale, P. marlariae
    • Asia, Latin America, North Africa, Eastern Europe, South Pacific
  9. Disease through insect bites: malaria prophylaxis quick start (1-2 days)
    • daily, no go with preggos
    • atovaquone/proguanil (Malarone) - 1 week after
    • doxycycline (Doryx, Vibramycin) - 4 weeks after - protect from sun SPF 30+
    • primaquine - 1 week after (p. vivax) - NO in G6PD deficiency
  10. Disease through insect bites: malaria prophylaxis advance start (1-2 weeks)
    • weekly, ok in preggo and children
    • Chloroquine (NOT good for P. falciparum, vivax resistance), 4 weeks after
    • mefloquine (Lariam), 4 weeks after, NO in psych, seizures, arrhythmias
  11. Disease through insect bites: Yellow fever locations
    • Virus
    • tropical and subtropical areas in Africa and Central and South America
  12. Disease through insect bites: Yellow fever treatment
    • symptomatic relief of flu-like sx
    • fluids, analgesics, antipyretics
    • NO aspirin/NSAIDS = increased risk for bleeding
  13. Disease through insect bites: Yellow fever vaccines
    • YF-VAX: live, attenuated
    • yellow card good within 10 days
    • lifelong ok, some countries still boost every 10 years
    • NO NO for egg allergy
  14. Altitude sickness prophylaxis
    • commonly above 8,000 feet, esp if lived close to sea level or previous hx of altitude sickness
    • Drug: acetazolamide (Diamox) 125 mg BID before or day of, higher dose = treatment 
    • NO NO in sulfa allergy 
  15. Motion sickness treatment
    • antihistamines: cyclizine (Marezine), diphenhydramine (Benadryl), dimenhydrinate (Dramamine), meclizine (Bonine, Dramamine All Day Less Drowsy)
    • Anticholinergic: scopolamine (Transderm Scop) - lasts 3 days behind ear - TAKE OFF in MRI!
    • watch for drowsiness!!
  16. Disease through insect bites: Dengue locations
    • transmitted by Aedes aegypti and Aedes albopictus mosquitoes
    • tropics and subtropics (high mosquito population and rainfall optimal for breeding)
    • NO vaccine
    • protect from mosquito bites and supportive care
  17. Disease through insect bites: Japanese encephalitis locations
    • mosquitos transmission
    • rural agricultural areas, Asia, parts of western Pacific
  18. Disease through insect bites: Japanese encephalitis vaccines
    Ixiaro - 2+ months who are spending at least 1 month camping in the risky areas/season
  19. Disease through insect bites: Zika Virus locations
    • transmitted by Aedes mosquito
    • NO vaccine
    • avoid mosquitos, wear condoms to reduce transmission
    • causes microcephaly
  20. LAW: independently administer ROUTINE immunizations - age
    3 + yo
  21. LAW: independently administer NON-ROUTINE immunizations -age
    3+ yo AND with physician-directed protocol
  22. LAW: T/F can administer epinephrine or diphenhydramine
    TRUE to severe allergic rxn
  23. LAW: requirements for vaccinating
    pharmacist + interns (BOTH must have it): trained in a ACIP/CDC approved program, BLS, 1 hr CE every 2 years
  24. LAW: notification of other healthcare providers
    • PCP + prenatal care provider (if applicable) within 14 days
    • California Immunization Registry (CAIR): pharmacies need to be enrolled, optional for pharmacists

    Vaccine admin records kept for each patient
Author
VASUpharm14
ID
341652
Card Set
Travelers medicine/vaccines
Description
outside time
Updated