Pharmacology for Dentistry

444 Section 13/ Miscellaneous

used as part of postexposure treatment. It
may also be used as preexposure prophy-
laxis against rabies in high risk persons like
dog handlers etc.

Rabies vaccines may be
i. Purified chick embryo cell rabies
vaccine.
ii. Inactivated rabies vaccine prepared on
vero cells. This vaccine for the pre or
postexposure immunization against
rabies is obtained by culture on vero
continuous cell lines.
iii. Human diploid cell rabies vaccine.
iv. Highly purified duck embryo rabies
vaccine.
Adverse effects include pain,
reddening and swelling at injection site,
swollen lymph nodes, joint pains and GI
complaints.

It is indicated for immunization
against rabies after exposure and for
prophylactic vaccination against rabies
before exposure.

Dosage: Vaccine should be given
intramuscular in the deltoid region only.

a. Preexposure: 3 dose IM injections on

day 0, 7 and 28. A booster dose after

one year and one dose after every five

years. In case of subsequent exposure,

only two doses at day 0 and day 3

provide protection, if proper previous

vaccination status is available.

b. Postexposure: After exposure start

immediately a full course of treatment

for both adults and children consists

of 5 injections on days 0 (day of

exposure), 3, 7, 14 and 30. A booster

dose on day 90 is optional.

MEASLES VACCINE

It contains live attenuated Edmonston-

Zagreb strain of measles virus propagated

on human diploid cells.

Adverse effects include fever which

may be accompanied by skin rash, malaise,

cough, headache and rarely febrile

convulsions.

It is indicated for active immunization

of children and susceptible adults by SC

route in a dose of 0.5 ml.

TETANUS TOXOID

It is a sterile uniform suspension of

tetanus toxoid adsorbed on aluminium

phosphate and suspended in isotonic saline

used for active immunization against

tetanus.

Adverse effects include mild local

reactions, tenderness and induration at the

site of injection.

Dosage:

For active primary immunization: Two

doses of 0.5 ml each by IM route at an

interval of four to six weeks. Reinforcing

dose should be given, six to eight months

later, to increase the level of immunity.

Booster dose: In previously immunized

persons, a booster dose of 0.5 ml IM should

be given every five years to maintain

adequate level of immunity. The need for

tetanus vaccine in wound management

depends both on the condition of the

wound and immunisation history of the

patient. For tetanus prone wound, tetanus

immunoglobulin may also be required.