Menu

Home
About Us
Products
Seminars
Hospitals
Discussions
Resources
Ed4StudentNurses
Coaching4Nurses
2 Minute EBP Challenge
Articles
Ed4Nurses LIVE
FAQs
Inspiration
See Us On YouTube
Nurses Success Network

Featured Programs

Search

 

2 Minute EBP Challenge

Monday, July 26, 2010
Ms. Shepard and DIC
This morning rapid response is called for Ms. Shepard who was admitted with a urinary tract infection and sepsis. Her blood pressure dropped during the evening hours and she is now hypotensive and is having difficulty breathing. Her IV sites are oozing and there is blood in the urinary catheter. Her physician suspects disseminated intravascular coagulation (DIC). The primary mechanism in the development of DIC is:

Monday, July 19, 2010
Thyrotoxicosis

Which of the following laboratory findings is indicative of thyrotoxicosis?

Monday, July 12, 2010
Urban CPR Patterns
In a recent study of inner-city neighborhoods, the authors found that out of hospital cardiac arrest was 2-3 times higher in some neighborhoods compared to others. In these high incidence neighborhoods what was the rate of bystander CPR?

Subscribe
  
Archives
<July 2010>
>>SunMonTueWedThuFriSat
>27282930123
>45678910
>11121314151617
>18192021222324
>25262728293031
>1234567
Categories
 
Home > 2 Minute EBP Challenge > Acetaminophen and vaccinations

Acetaminophen and vaccinations

Monday, November 02, 2009
 

Stay up-to-date the easy way!

How would you answer this question?

Administering acetaminophen (Tylenol) at the time of pneumococcal or influenza vaccination may decrease fever and discomfort associated with vaccination, but is also associated with:

a. Fever greater than 38 degrees C
b. Swelling at the injection site
c. Irritability in infants
d. Decreased antibody responses

The correct answer is "d," decreased antibody response.

Acetaminophen (Tylenol) is often classified as a non-steroidal anti-inflammatory (NSAID) medication due to its action on cyclooxygenase 3 (COX3), which is very similar to COX1 that is blocked by other traditional NSAIDs.  The main effects of acetaminophen are the relief of fever and pain.  Acetaminophen is often prescribed for the relief of discomfort of vaccination injections.  In a recent study, the authors found a significant reduction in fever, pain, and irritability after vaccination in children who were premedicated with acetaminophen.

Acetaminophen is not thought to reduce inflammation though, so theoretically it should not interfere with immunogenicity of vaccinations.  However, in their study, Prymula, et al. found a significant reduction in antibody responses to vaccination in the pretreated group.  Given the long history of administration of acetaminophen with vaccinations, it is likely that the magnitude of immune suppression caused by acetaminophen is primarily found in laboratory testing and not in clinical expression of disease.

The authors recommend avoiding the prophylactic use of acetaminophen for vaccinations, unless the patient has moderate to severe complications from vaccinations.

From: Prymula, R. et al. (2009).  Effect of prophylactic paractamol administration at the time of vaccination on febrile reactions and antibody response in children: Two open-label randomised controlled trials.  Lancet, 374:1339.

Congratulations to Susan Weiss who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question correctly.  Congratulations Susan!     

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.

(c) 2009 Ed4Nurses, Inc.  Feel free to print this e-mail and share it with your colleagues. Other forms of digital or print reproduction are prohibited without prior written consent from Ed4Nurses, Inc.
Print this page