Compound
AC toxoid consists of purified tetanus toxoid adsorbed on an aluminum hydroxide gel. The drug contains 20 binding units (EC) of tetanus toxoid per 1 ml. Preservative - merthiolate at a concentration of 0.01%.
Description
The drug is a yellowish-white suspension, which separates upon settling into a clear supernatant liquid and a loose sediment that breaks up when shaken.
Indications for use
Clinical contraindications to routine vaccinations with AC toxoid:
1. Acute infectious and non-infectious diseases - vaccination is carried out no earlier than one month after recovery.
2. Exacerbation of chronic diseases - vaccination is carried out in a state of clinical and laboratory remission.
3. Long and serious illnesses (viral hepatitis, tuberculosis, meningitis, myocarditis, diffuse diseases connective tissue etc.) - vaccination is carried out individually 6-12 months after recovery.
4. Severe forms allergic reactions to the administration of ADS, ADS-M, AD-M, AS-anatoxins (shock, Quincke's edema, polymorphic exudative erythema, etc.).
5. Severe post-vaccination reactions in the form anaphylactic shock, encephalitis, agranulocytosis - vaccination is carried out no earlier than 6 months after recovery (remission).
6. Hereditary and progressive neurological and joint diseases, sub- and decompensated hydrocephalus, acute disorders cerebral circulation, seizures more often than once every 6 months, epilepsy and epileptic syndrome with seizures no more than once in 6 months.
Note. Children with non-progressive cerebral palsy and other stable neurological disorders can be vaccinated with ADS-M toxoid after the age of one year; children with convulsive syndrome in history, they can be vaccinated with ADS-M toxoid 6 months after an attack against the background of anticonvulsant therapy.
7. Immunity disorders: oncological diseases, immunosuppression as a result of cytostatic therapy and the use of corticosteroids for more than 14 days. Such children can be vaccinated 1 month after discontinuation of these treatment methods.
8. Anemia: contraindications for vaccination are patients with a hemoglobin level below 80 g/l.
Vaccination with AC toxoid is carried out no earlier than 2 months after vaccination against other infections.
In each individual case of a disease that is not on the list of contraindications, the question
contraindications for vaccination are decided by the commission.
In order to identify contraindications, the doctor (federal assistant of the FAP) on the day of vaccination conducts a survey and examination of persons who are being vaccinated, with mandatory thermometry. Persons temporarily exempt from vaccinations must be supervised and registered and promptly vaccinated after the contraindications are lifted.
Contraindications
1. History hypersensitivity to the appropriate drug.
2. Pregnancy:
- in the first half, the administration of AS-anatoxin and PSS is contraindicated;
- in the second half, the administration of PSS is contraindicated.
Directions for use and doses
1. Active immunization
The drug is injected subcutaneously into the subscapular region. A full course of immunization with AC toxoid for adults consists of two vaccinations of 0.5 ml each with an interval of 30-40 days and revaccination after 6-12 months with the same dose. With an abbreviated schedule, the full course of immunization includes a single vaccination with AC toxoid in a double dose (1.0 ml), revaccination after 1-2 years with a dose of 0.5 ml and then every 10 years.
Immunization of some populations (elderly people, unorganized population), taking into account specific conditions in certain areas, according to the decision of the Ministry of Health of Ukraine, can be carried out according to an abbreviated scheme, providing for a single vaccination with AC toxoid in a double dose (1.0 ml) and revaccination after 1-2 years with a dose of 0.5 ml and then every 10 years.
Note;
1. Active immunization of children against tetanus from 3 months of age is carried out routinely with adsorbed diphtheria-tetanus pertussis vaccine (DPT vaccine) or adsorbed diphtheria-tetanus toxoid (ADS-toxoid, ADS-M-toxoid) in accordance with the guidelines for " use of drugs.
2. Revaccinations of adults previously fully immunized with associated drugs containing tetanus toxoid are carried out every 10 years with AC or ADS-M toxoids in a dose of 0.5 ml.
3. Persons who have not previously been vaccinated against tetanus (from 26 to 56 years of age) who have received a single dose of ADS-M toxoid for the prevention of diphtheria, in order to form full immunity to tetanus, 30-40 days after the administration of ADS-M toxoid, are administered AC-antoxin in a dose 0.5 ml. Revaccination is carried out after 6-12 months once with the same dose of AC toxoid.
2.Emergency prophylaxis of tetanus
Emergency prevention of tetanus includes primary surgical treatment of the wound and simultaneous specific immunoprophylaxis.
Emergency specific prophylaxis of tetanus is indicated for:
Injuries involving violation of the integrity of the skin and mucous membranes;
Frostbite and burns (thermal, chemical, radiation) of the second, third and fourth degree;
Out-of-hospital abortions;
Childbirth outside medical institutions;
Gangrene or tissue necrosis at any stage; abscesses;
Animal bites;
Penetrating injuries of the gastrointestinal tract.
For emergency specific prevention of tetanus, the following is used:
Adsorbed tetanus toxoid (AS-a);
Adsorbed diphtheria-tetanus toxoid (ADS-a) with reduced antigen content (ADS-M-a);
Antitetanus human immunoglobulin(PSCHI), made from blood immune people. One prophylactic dose of PSCI contains 250 international units (IU);
Antitetanus serum (ATS), obtained from the blood of hyperimmunized horses. One prophylactic dose of PSS is 3000 IU.
Selection scheme prophylactic agents when carrying out emergency specific prophylaxis of tetanus is presented in Table No. 1.
AC toxoid is injected subcutaneously into the subscapular region.
PSCH is administered in a dose of 250 IU intramuscularly into the upper outer quadrant of the buttock.
PSS is administered in a dose of 3000 IU subcutaneously.
Before administering PSS, an intradermal test with horse serum diluted 1:100 is required to determine sensitivity to horse serum proteins (the ampoule is marked in red).
To carry out an intradermal test, use an individual ampoule and a sterile syringe with graduations of 0.1 ml and a thin needle.
The diluted serum is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml. The reaction is recorded after 20 minutes. The test is considered negative if the diameter of the swelling or redness at the injection site is less than 1.0 cm. The test is considered positive if the swelling or redness reaches a diameter of 1.0 cm or more. When negative skin test PSS (from an ampoule marked in blue) is injected subcutaneously in a volume of 0.1 ml. If there is no reaction, after 30 minutes, inject the rest of the dose of serum with a sterile syringe, the ampoule with which should be stored closed with a sterile napkin.
Comment. Persons with allergic diseases and reactions to various allergens, as well as for those who have previously been administered drugs with horse serum (PSS, anti-rabies and oral and encephalic heterogeneous gamma globulins), before administering the main dose of PSS, it is recommended to administer antihistamines. For persons with a positive reaction to intradermal injection of 0.1 ml of horse serum diluted 100 times, or those who had a reaction to subcutaneous injection of 0.1 ml of PSS, further administration of PSS is contraindicated.
Active routine immunization and emergency specific prevention tetanus is carried out in compliance with the following rules:
Before use, the ampoule of the drug is carefully inspected;
The drug cannot be used if there is no label on the ampoule, there are cracks in the ampoules, there are foreign inclusions, there is sediment, the expiration date has expired, or improper storage;
Immediately before administering AS-anatoxin, the ampoule is shaken until
homogeneous mixture;
Before opening, the ampoule is wiped with cotton wool moistened with alcohol before and after the cut with a file. Opened ampoule with AS-toxoid or PSS can be stored, covered with a sterile napkin, for 30 minutes;
This product is available in the form of a yellowish-white suspension intended for internal administration.
pharmachologic effect
The medicine is used for active immunization against .
Pharmacodynamics and pharmacokinetics
Tetanus toxoid (Anatoxin-AS) is characterized by antitoxic , immunocorrective And immunomodulatory action. Administration of the drug leads to the formation immune response against tetanus with the formation of specific .
After vaccinations human body becomes immune to these foreign agents. The effect of the medicine can last up to several years. But for stable immunity to infection, you need to do several injections .
Indications for use
This product is used for active immunization against tetanus and in case of need for urgent prevention tetanus with or tissues, injuries with violation of the integrity of the skin and mucous membranes, community-acquired, animal bites, frostbite and burns , childbirth outside of medical institutions, penetrating injuries of the gastrointestinal tract.
Contraindications
There are no contraindications for urgent prophylaxis of tetanus. In case of planned vaccinations tetanus toxoid not used for acute infectious diseases And chronic diseases at the acute stage. In addition, it is contraindicated in the first trimester, in case of immunodeficiency states , negative reaction to the components of the drug.
Side effects
Mostly, negative reactions reported include: malaise , temperature increase, . These symptoms usually go away on their own within two days.
In addition, sometimes such local side effects like redness or painful sensations at the injection site. They also go away on their own within two days.
When adverse reactions There is no need to discontinue use of the drug. In some cases, it may be necessary to increase the time interval between drug administrations.
When using tetanus toxoid may also appear: polymorphic rash , . For this reason, patients should be monitored for 30 minutes after injection. The vaccination site must be equipped with means antishock therapy .
Instructions for use of Tetanus Anatoxin (Method and dosage)
The instructions for Tetanus Anatoxin indicate that the drug is injected subcutaneously into the area under the scapula. Full course injections for people who have not previously been vaccinated against tetanus , includes two vaccinations 0.5 ml each. There should be a break of 30-40 days between them. Subsequent revaccination carried out six months or a year later in the same dosage. In some cases, this interval is extended to 2 years. Next are revaccination every 10 years. The drug is administered once in a dosage of 0.5 ml.
Vaccinations Some hard-to-reach populations may be provided with a reduced scheme. IN in this case injection do it in double dosage. First revaccination carried out after 6-24 months. Further revaccination are held every 10 years. Dosage – 0.5 ml.
Active vaccination children (age from 3 months) vs. tetanus carry out ADS toxoid , or -anatoxin , following the instructions for use.
Revaccination adult patients fully vaccinated with associated agents, including tetanus toxoid , are carried out every 10 years.
If necessary emergency prevention tetanus primary debridement wounds. Injection should be done at the first opportunity from the moment of injury until the 20th day. AC toxoid is used, antitetanus human immunoglobulin . If it is missing, they can use equine antitetanus serum , which is purified through peptic digestion.
AC toxoid is injected under the shoulder blade subcutaneously . Dosages PSCH – 250 ME intramuscularly . Injections done in the upper outer quadrant of the buttock. In its turn, PSS introduced subcutaneously at a dosage of 3000 ME.
Overdose
No information on overdose was provided.
Interaction
In case of emergency prophylaxis, Tetanus toxoid must be administered to different areas. Various syringes are used for this.
Terms of sale
This drug is the same as Anatoxin Cholerogen and many others toxoids , not sold in the pharmacy chain. It is supplied only to medical institutions.
Storage conditions
The drug must be kept in a dry and dark place. The optimal temperature is about 6°C. Ampoules should not be frozen. They can also be transported at a temperature of about 6°C in covered transport.
May be required in emergency situations accompanied by a violation of the integrity of the skin. Several drugs are used for this. The introduction must be carried out strictly by a specialist, taking into account general condition the victim. What drugs are used? Why is prevention carried out?
Tetanus
This disease is caused by a bacterial pathogen. Infection occurs by contact when microorganisms enter the bloodstream through damaged skin. The disease is dangerous because its target is the central nervous system. Its damage is characterized by severe generalized convulsions and general tension in skeletal muscle tone.
Clinical manifestations are due to the fact that, upon entering the human body, the bacterium begins to produce tetanus toxin. Tetanospasmin, which is part of it, causes pronounced tonic muscle contractions. In addition, tetanohemolysin accumulates in the body, which causes damage and death of red blood cells (hemolysis). Uncoordinated propagation of impulses is noted, and the excitability of the cerebral cortex increases. Later it is affected respiratory center, which can cause death.
Anatoxin
Purified and adsorbed on the gel, tetanus toxoid is used to form immunity to the pathogen. It is used for planned and emergency prevention.
After recovery, the patient does not acquire immunity to the pathogen. This suggests that there is a risk of re-infection. This is why it is necessary to use tetanus toxoid. Externally it looks like a suspension yellowish color. During storage, it is divided into two parts - transparent liquid and sediment. Available in 0.5 ml, which is one vaccination dose. This amount contains tetanus toxoid - 10 EU. It also contains a sorbent and a preservative. Liquid for injection is in 1 ml ampoules.
Carrying out emergency prevention
To prevent the development of the disease, administer the following drugs: tetanus toxoid, tetanus immunoglobulin and The choice of one or another drug, their combination depends on clinical case. If they have been diagnosed and the person has documentation confirming this fact, prophylactic injections are not performed. Missing only one last scheduled vaccination is an indication for toxoid administration. If several injections have been missed, a combination of toxoid and immunoglobulin is required. The serum is administered to children under 5 months of age who have not yet undergone routine prophylaxis. The situation is most difficult for pregnant women. In such cases, any administration of prophylactic drugs in the first half of pregnancy is prohibited, and in the second half only serums are contraindicated. This is why routine disease prevention is so important.
Tetanus toxoid is often used. The instructions, although simple, can only be introduced in specialized institutions.
Planned prevention
To prevent the occurrence of such a terrible disease as tetanus, timely administration of combination vaccine carried out as planned. Tetanus toxoid is the neutralized toxins of tetanus bacteria. They cannot cause harm to the body; on the contrary, they contribute to the formation of substances to combat the active toxin. The use of toxoid is the basis of prevention.
On this moment used for routine prevention DTP vaccine- not only against tetanus, but also whooping cough and diphtheria.
Tetanus toxoid: instructions for use
The vaccine is administered routinely and intramuscularly, subcutaneous injections are not allowed, as they lead to the formation of compactions. It is preferable to inject the drug into the deltoid muscle in adults and into the anterolateral surface of the leg (middle) in children under 3 years of age. The routine prevention procedure includes three vaccines. They are administered at an interval of 1.5 months and starting from 2 months of the baby’s life. Revaccination - one year after the third.
Side effects
Vaccinations often cause mild side effects. This indicates correct formation immune system and will soon pass. However, parents should be wary and contact their pediatrician if the reaction to the vaccine is intense. At the injection site, a local reaction may normally occur - slight swelling, hyperemia and soreness. The child is worried about decreased appetite, vomiting, increased body temperature and diarrhea. If necessary, antipyretic drugs may be taken. Among the complications are allergic reaction. It is not harmful if it only appears skin rash. However, if the baby develops Quincke's edema or convulsions, you should immediately call ambulance. In any case, planned prevention should be monitored by a pediatrician at all stages. This will avoid serious complications. Specialists will provide correct introduction a drug such as tetanus toxoid. Its use must be strictly according to the instructions.
Prevention is mandatory event which is carried out as planned. This complex helps prevent the development of tetanus, which is considered an extremely dangerous disease.
Considering that after the administration of PSS and drugs containing tetanus toxoid, especially sensitive people shock may develop, each vaccinated person must be provided with medical supervision for an hour after vaccination, and the room in which vaccinations are carried out must be provided with anti-shock therapy.
The patient should be informed that if severe malaise occurs after administration of the vaccine, accompanied by headache, fever or local reaction with swelling and redness, or symptoms of serum sickness, he should immediately seek medical help.
1. Emergency prevention of tetanus is carried out in compliance with the following rules:
1.1. Before administration, the ampoule with the drug is carefully examined. The drug cannot be used in following cases:
- if there is no label on the ampoule;
- if there is no complete information about the drug on the label;
- if there are cracks in the ampoule;
— in the presence of unbreakable flakes, sediment or foreign inclusions (fibers, burnt marks, etc.);
- if the drug has expired;
- in case of improper storage of the drug.
1.2. Immediately before administering the AS, the ampoule is shaken until a homogeneous suspension is obtained.
1.3. When opening the ampoule, before and after making an incision with a file, wipe it with sterile cotton wool moistened with alcohol. An opened ampoule of AS or PSS can be stored covered with a sterile napkin for 30 minutes.
1.4. The drugs are drawn into a syringe from an ampoule using a long needle with a wide bore. A different needle must be used for injection.
1.5. The skin at the injection site is disinfected with 70% alcohol; After administering the drug, the injection site is lubricated with iodine or alcohol.
2. Emergency prevention by revaccination of AS. AC is administered in an amount of 0.5 ml in accordance with the instructions for the drug. If the localization of the wound allows, it is preferable to inject AC toxoid into the region of its location by subcutaneous injection.
3. Active - passive prevention of tetanus. AC is administered in an amount of 1 ml, in accordance with the instructions for the drug. At the same time, PSCH 250 IU is injected intramuscularly into another area of the body; in the absence of PSCH, 3000 IU PSS is administered.
3.1. Before introducing PSS into mandatory An intradermal test is performed with horse serum diluted 1:100 to determine sensitivity to horse serum proteins (the ampoule is marked in red).
An intradermal test is not performed if the victim, within 1 to 3 days before the administration of PSS, was tested with a 1:100 diluted anti-rabies gammaglobulin from horse serum due to the need to administer rabies gammaglobulin.
To take the sample, use an individual ampoule, as well as sterile syringes with 0.1 ml graduations and a thin needle. The serum diluted 1:100 is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml. The reaction is recorded after 20 minutes. The test is considered negative if the diameter of the swelling or redness at the injection site is less than 1.0 cm; the test is considered positive if the swelling or redness reaches a diameter of 1.0 cm or more.
3.2. If the skin test is negative, PSS (from an ampoule marked in blue) is injected subcutaneously in a volume of 0.1 ml. If there is no reaction after 30 minutes, inject the remaining dose of serum with a sterile syringe. During this time, the opened ampoule with PSS should be covered with a sterile napkin.
Note. Persons with allergic diseases and reactions to various allergens, as well as those who have previously received drugs containing horse serum (PSS and others) or heterologous gammaglobulins (anti-rabies, anti-encephalitis, etc.) are recommended to administer antihistamines before administering the main dose of PSS.
Persons with positive reaction to intradermal administration of 0.1 ml of horse serum diluted 1:100 or who had a reaction to subcutaneous administration of 0.1 ml of PSS, further administration of PSS is contraindicated.
An example of recording a protocol for emergency tetanus prophylaxis from a medical history.
16.45 SA was administered subcutaneously at a dose of 1.0 ml p.20-110, valid until 12.2013.
There was no reaction to the injection.
17.00 An intravenous test of 0.1 ml of diluted (1:100) PSS p.75-0511 was made, valid until 06.14.
17.20 The test is negative.
17.30 0.1 ml of undiluted PSS p.19-0511 was administered subcutaneously, valid until 06.14.
There was no reaction to the injection.
18.15 3000 IU PSS was administered intramuscularly p. 19-0511, valid until 06.14.
The injection was tolerated satisfactorily, there was no reaction to the injection.
An example of an epicrisis in a medical history.
Patient F.I.O., 25 years old, was admitted to hospital No. 03/28/12 for emergency prophylaxis of tetanus due to laceration 2nd finger of the left hand.
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