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 a reddening of the skin, Pain, Acute, related to IM injection
(recombinant) been shown to hepatitis B infection during their lifetime, weakness, of the vaccine
elicit antibodies so getting the hepatitis B vaccine feeling unwell (malaise),
BRAND: to hepatitis B should be considered by all people. nausea, vomiting, Knowledge, Deficient, related to
Engerix-B, virus as There are, however, groups that the abdominal pain/cramps, hepatitis B vaccination
Hepaccine, measured by CDC recommends should definitely difficult or
HBV, ELISA. Antibody receive the hepatitis B vaccine, which labored breathing,
Recombivax concentrations are listed below: diminished appetite, stuffy Intervention and Rationale:
≥10mIU/mL  All infants, beginning at birth nose, influenza, cough, Communicate or assure patient
PHARMACOLOGIC against HBsAg  All children aged <19 years who sweating, achiness, that the pain due to injection is mild
CLASS: are recognized have not been vaccinated sensation of warmth, and generally tolerable.
Hepatitis B vaccine as conferring previously lightheadedness, chills, Rationale: To make patient more
protection  Susceptible sexual partners of flushing diarrhea, sore comfortable
THERAPEUTIC CLASS: against hepatitis B-positive persons throat, upper respiratory
ANTI- HEPATITIS b hepatitis B  Sexually active persons who are infection, burning, nodules, Provide immunization schedule to
VACCINE infection. not in a long-term, mutually headache, fever, spinning client (Vaccination requires three
Infection with monogamous relationship (e.g., sensation (vertigo), IM injections at prescribed
DOSAGE FORMS hepatitis B virus >1 sex partner during the previous numbness or tingling, skin intervals.)
AND STRENGTHS: can have 6 months) swelling, hives, muscle Rationale: For family to understand
ENGERIX-B is a serious  Persons seeking evaluation or pain, back pain, neck dosing schedule and the health
sterile suspension consequences treatment for a sexually pain, shoulder pain, worker to be assured completion of
available in the including transmitted disease stiff neck, earache the vaccination
following acute massive  Men who have sex with men inability
presentations: hepatic  Injection drug users to sleep (insomnia), Administer dosage correctly.
0.5-mL (10 mcg) necrosis and  Susceptible household contacts irritability, joint pain, (Vaccine must be administered
prefilled syringes ; chronic active of hepatitis B-positive persons constipation, Lupus- intramuscularly.)
1-mL (20 mcg) hepatitis.  Healthcare and public safety like syndrome (rash, joint Rationale: To prevent side effects
single-dose vials Chronically workers at risk for exposure to pain and fatigue), Systemic like pain and fever as well as
and prefilled infected blood LupusErythematous (autoi underdosing/overdosing
syringes persons are at  Persons with end-stage renal mmune disease),
increased risk disease, including pre-dialysis, polyarthritis nodules,
for cirrhosis and hemodialysis, peritoneal dialysis, enlargement Client Education:
hepatocellular and home dialysis patients of lymph nodes, fast heart Instruct client to return at 1 month
carcinoma  Residents and staff of facilities for rate, fainting, after the first injection for the
developmentally disabled persons inflammation of second dose and at 6 months after
 Travelers to and families adopting the cornea, inflammation the first injection for the third dose.
from countries where hepatitis B is of the optic nerve, ringing
common (e.g. Asia, Africa, South in the ears (tinnitus),
 America, Pacific Islands, Eastern
Source: Europe, and the Middle East)
https://aidsinfo.  Persons with chronic liver disease,
nih.gov/drugs/ other than hepatitis B (e.g.
504/hepatitis-b- cirrhosis, fatty liver disease, etc.)
vaccine/166/pr  Persons with hepatitis C infection
ofessional  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 sedi
mentation 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/con
sumer_hepatitis_b_vaccine
_energix_recombivax/drug
s-condition.htm
Instruct client about:
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.