Meningococcal conjugate vaccine and Norepinephrine Bitartrate

• Generic Name: meningococcal conjugate vaccine
• Dosage Forms: n.a.
• Other Brand Names: Menactra, Menveo

Meningococcal disease is a serious infection caused by a bacteria. Meningococcal bacteria can infect the spinal cord and brain, causing meningitis that can be fatal. Meningococcal disease can also lead to permanent and disabling medical problems.

Meningococcal disease can spread from one person to another through small droplets of saliva that are expelled into the air when an infected person coughs or sneezes. The bacteria can also be passed through contact with objects the infected person has touched, such as a door handle or other surface. The bacteria can also be passed through kissing, or sharing a drinking glass or eating utensil with an infected person.

Meningococcal disease is more likely to occur in babies younger than 1 year, in young people ages 16 to 23 years, in anyone with a weak immune system, and in anyone exposed to an outbreak of the disease.

Meningococcal conjugate vaccine is used to prevent infection caused by meningococcal bacteria. The vaccine works by exposing you to a small dose of the bacteria or a protein from the bacteria, which causes your body to develop immunity to the disease. Meningococcal conjugate vaccine contains four of the most common types of meningococcal bacteria (serogroups A, C, W, and Y).

This vaccine will not treat an active meningococcal infection that has already developed in the body.

Meningococcal conjugate vaccine is for use in children and adults between the ages of 9 months and 55 years old.

Like any vaccine, meningococcal conjugate vaccine may not provide protection from disease in every person.

• Generic Name: norepinephrine
• Dosage Forms: n.a.
• Other Brand Names: Levophed, Levophed Bitartrate

Used as adjunctive therapy to produce vasoconstriction and maintain BP in the management of certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, MI, septicemia, blood transfusion, drug reactions).

Pressor therapy is not a substitute for replacement of blood, plasma, fluids, and/or electrolytes. Correct blood volume depletion as fully as possible before administration.

The Surviving Sepsis Campaign International Guidelines for Management of Sepsis and Septic Shock recommend norepinephrine as the vasopressor of choice in adults with septic shock; if adequate BP not achieved, vasopressin or epinephrine may be added. Vasopressin also may be given in conjunction with norepinephrine to reduce dosage requirements of norepinephrine.

Also used to provide vasopressor support in other types of shock (e.g., cardiogenic, hemorrhagic), generally as a temporary measure until underlying cause can be treated.

In patients who are hypotensive from blood volume deficits, manufacturer states to use norepinephrine only as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed.

Early revascularization is standard of care in patients with cardiogenic shock; individualize use of vasopressors in this setting.

Has been used to treat hypotension during spinal anesthesia; however, other vasopressors with a longer duration (e.g., phenylephrine) more commonly used.

Used adjunctively in the management of cardiac arrest to restore and maintain adequate BP after an effective heartbeat and ventilation have been established by other means.

High-quality CPR and defibrillation are the only proven interventions to increase survival to hospital discharge in ACLS. Other resuscitative efforts, including drug therapy, are considered secondary and should be performed without compromising the quality and timely delivery of chest compressions and defibrillation.

Principal goal of pharmacologic therapy during cardiac arrest is to facilitate the return of spontaneous circulation (ROSC), and epinephrine is the drug of choice for this use. Vasoactive drugs such as norepinephrine may be used for hemodynamic support following resuscitation.