DRUG NAME MECHANISM INDICATION / CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES

OF ACTION
GENERIC: Hepatitis B INDICATIONS: pain, severe itching, Nursing Diagnosis
Hepatitis B vaccine vaccine has Every person may be at some risk for reddening of the skin, Pain, Acute, related to IM injection
(recombinant) been shown to a hepatitis B infection during their weakness, of the vaccine
elicit lifetime, so getting the hepatitis B feeling unwell (malaise),
BRAND: antibodies to vaccine should be considered by all nausea, vomiting, Knowledge, Deficient, related to
Engerix-B, hepatitis B people. There are, however, groups abdominal pain/cramps, hepatitis B vaccination
Hepaccine, virus as that the CDC recommends should difficult or
HBV, measured by definitely receive the hepatitis B labored breathing,
Recombivax ELISA. vaccine, which are listed below: diminished appetite, Intervention and Rationale:
Antibody  All infants, beginning at birth stuffy nose, influenza, Communicate or assure patient
PHARMACOLOGI concentrations  All children aged <19 years cough, sweating, that the pain due to injection is
C CLASS: ≥10mIU/mL who have not been vaccinated achiness, sensation of mild and generally tolerable.
Hepatitis B against HBsAg previously warmth, lightheadedness, Rationale: To make patient more
vaccine are recognized  Susceptible sexual partners of chills, flushing diarrhea, comfortable
as conferring hepatitis B-positive persons sore throat, upper
THERAPEUTIC protection  Sexually active persons who respiratory infection, Provide immunization schedule to
CLASS: against are not in a long-term, mutually burning, nodules, client (Vaccination requires three
ANTI- HEPATITIS b hepatitis B monogamous relationship (e.g., headache, fever, spinning IM injections at prescribed
VACCINE infection. >1 sex partner during the sensation (vertigo), intervals.)
Infection with previous 6 months) numbness or tingling, skin Rationale: For family to
DOSAGE FORMS hepatitis B  Persons seeking evaluation or swelling, hives, muscle understand dosing schedule and
AND virus can have treatment for a sexually pain, back pain, neck the health worker to be assured
STRENGTHS: serious transmitted disease pain, shoulder pain, completion of the vaccination
ENGERIX-B is a consequences  Men who have sex with men stiff neck, earache
sterile suspension including  Injection drug users inability Administer dosage correctly.
available in the acute massive  Susceptible household contacts to sleep (insomnia), (Vaccine must be administered
following hepatic of hepatitis B-positive persons irritability, joint pain, intramuscularly.)
presentations: necrosis and  Healthcare and public safety constipation, Lupus- Rationale: To prevent side effects
0.5-mL (10 mcg) chronic active workers at risk for exposure to like syndrome (rash, joint like pain and fever as well as
prefilled syringes ; hepatitis. blood pain and fatigue), underdosing/overdosing
1-mL (20 mcg) Chronically  Persons with end-stage renal Systemic
single-dose vials infected disease, including pre-dialysis, LupusErythematous (autoi
and prefilled persons are at hemodialysis, peritoneal dialysis, mmune disease), Client Education:
syringes increased risk and home dialysis patients polyarthritis nodules, Instruct client to return at 1
for cirrhosis  Residents and staff of facilities enlargement month after the first injection for
and for developmentally disabled of lymph nodes, fast heart the second dose and at 6 months
hepatocellular persons rate, fainting, after the first injection for the
carcinoma  Travelers to and families inflammation of third dose.
adopting from countries where the cornea, inflammation
hepatitis B is common (e.g. Asia, of the optic nerve, ringing
Africa, South America, Pacific in the ears (tinnitus), Instruct client about:
 Islands, Eastern Europe, and the
Source: Middle East)
https://aidsinfo  Persons with chronic liver
.nih.gov/drugs/ disease, other than hepatitis B
504/hepatitis- (e.g. cirrhosis, fatty liver
b- disease, etc.)
vaccine/166/pr  Persons with hepatitis C
ofessional infection
 Persons with HIV infection
 Adults with diabetes aged 19
through 59 years (clinicians can
decide whether or not to
vaccinate their diabetic patients
≥60 years)
 All other persons seeking
protection from HBV infection —
acknowledgment of a specific
risk factor is not a requirement
for vaccination
CONTRAINDICATION:
Severe allergic reaction (e.g.,
anaphylaxis) after a previous dose of
any hepatitis B-containing vaccine, or
to any component of hepatitis B
vaccine including yeast.
DRUG INTERACTION:
Severe Interactions of Hepatitis B
Vaccine include: Belimumab
Moderate Interactions of Hepatitis B
Vaccine include: daclizumab,
hydroxyurea, mercaptopurine,
methotrexate
Mild Interactions of Hepatitis B
Vaccine include: Chloroquine
pink eye (conjunctivitis),
visual disturbance,
inflammation of the eye,
agitation, sleepiness,
increased erythrocyte sed
imentation rate (ESR),
deficiency of platelets in
the blood, Steven-Johnson
syndrome, hair loss, red
or brown round spots on
the skin, eczema, Guillian-
Barre syndrome, multiple
sclerosis, inflammation of
the spinal cord, febrile
seizure, damage to
nerves in hands or feet,
Bell's palsy, herpes
zoster, migraine, muscle
weakness,
reduced sense of touch or
sensation, inflammation
of the brain (encephalitis),
hypersensitivity,
acute allergicreaction (an
aphylactic reaction),
sudden difficulty
breathing, skin eruptions,
discoloration of the skin
due to bruising
inflammation of blood
vessels, low blood
pressure (hypotension),
pain when urinating
Source:
https://www.rxlist.com/co
nsumer_hepatitis_b_vacci
ne_energix_recombivax/dr
ugs-condition.htm
That pain and inflammation at the
injection site are the most
common side effects.
To rest arm and apply heat for
symptoms of discomfort and to
take antiinflammatory
medications for pain.
Client Goals and Expected
Outcomes: The client will:
Adhere to recommended
immunization schedule.
Verbalize methods to decrease
pain related to injection.
Be free from adverse drug
reactions.
Outcomes Evaluation:
Evaluate the effectiveness of drug
therapy by confirming that client
goals and expected outcomes
have been met
The client verbalizes the
importance of adhering to the
immunization schedule
The client verbalizes methods to
decrease pain at the injection site.
The client is free of adverse drug
reactions.
The client demonstrates an
understanding of the drug’s action
by accurately describing drug side
effects and precautions.