Primary Care Medication Management for Healthy Infants- A Focus on Vaccination and Preventative Care

Primary Care Medication Management for Healthy Infants- A Focus on Vaccination and Preventative Care

Question One

For a healthy two-month-old child, the recommended vaccines typically include a combination of DTaP (diphtheria, tetanus, and acellular pertussis), Hib (haemophilus influenzae type b), IPV (polio), hepatitis B, and PCV13 (pneumococcal conjugate vaccine). These vaccines are crucial for protecting the child against serious infections (Katzung et al., 2021). The combination available at the clinic may vary, but a common combination would be Pentacel, which includes DTaP, Hib, and IPV. Hepatitis B is usually administered separately, and PCV13 is given as Prevnar.

Question Two

At 12 months, the child can receive additional vaccines such as MMR (measles, mumps, and rubella), Varicella (chickenpox), Hepatitis A, and the fourth dose of PCV13. These vaccines help ensure continued protection against various infectious diseases.

Question Three

Patients at higher risk for pneumococcal disease requiring PPSV23 starting at two years old include those with chronic illnesses (such as heart or lung disease), immunocompromised individuals, and those with cochlear implants (Katzung et al., 2021). The vaccine helps prevent severe pneumococcal infections in these vulnerable populations.

Question Four

St. John’s wort increases the activity of cytochrome P450 enzymes, which can also affect oral contraceptive efficacy. Moreover, it may interfere with many medications that affect their therapeutic levels, such as antiretrovirals and warfarin (Rosenthal & Burchum, 2021).

Question Five

Echinacea is often used to boost the immune system and alleviate common cold symptoms. It can be taken as a tea, extract, or supplement.

Question Six

While echinacea is generally considered safe for adults, its safety in children is not well-established. Due to potential risks and lack of sufficient evidence, the mother should consult with a healthcare professional before giving echinacea to her four-year-old child.

References

Katzung, B. G., Kruidering-Hall, M., Tuan, R. L., Vanderah, T. W., & Trevor, A. J. (2021). Katzung & Trevor’s pharmacology examination and board review (13th ed). McGraw Hill Professional.

Rosenthal, L.D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses (2nd ed.). Elsevier.

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Week 8: Discussion Question 1

Discussion Prompt
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)

Primary Care Medication Management for Healthy Infants- A Focus on Vaccination and Preventative Care

A healthy 2-month-old child was brought to your clinic by her parents. The child is a full-term infant with no concerns. Her exam is normal, and she received her Hep B #1 in the nursery.
• Q1. What vaccines does she get? What combinations are available at your clinic?
• Q2. The child returns at 12 months after completing her primary series of vaccines at 2, 4, and 6 months of age. Her vaccines are right on schedule, her parents have no concerns, she is developing normally, and her exam is normal. What vaccines can she get today?
• Q3. Which groups of patients are at higher risk for pneumococcal disease, and need PPSV23 early starting at 2 years old?
A 25-year-old woman comes to your office asking for oral contraceptive refills. She stated that she was feeling depressed and heard about St. John’s wort used in depression which she started taking a week ago.
• Q4. How might concomitant administration of St. John’s wort affect the efficacy of drugs this patient is taking such as the oral contraceptives? Discuss another example of a possible drug interaction that might occur with St. John’s wort.
The 25-year-old woman stated that her 4-year-old child had been coughing and sounded congested. She wants to know if echinacea might help her child.
• Q5. What is echinacea used for and how is it taken?
• Q6. Is it safe for this mother to give her child echinacea?