TETANUS TOXOID

A Drug Study Presented to

The Faculty of Nursing Department

In Partial Fulfillment of

the Requirement in NCM – 209 RLE

OB ROTATION

Submitted to:

CHARMAINE A. OROCIO, RN

Clinical Instructor

Submitted by:

JV J. VILLAHERMOSA

BSN-2L – GROUP 5

April 26, 2021

Generic Name Tetanus Toxoid

Brand Name 1. Bio-TT, TE Anatoxal Berna

Classification - Pharmacologic classification: Toxoid

- Therapeutic classification: Tetanus
Prophylaxis
- Tetanus bacterial vaccines.
Mode of Action Tetanus Toxoid induces active immunity to tetanus antigen by
stimulating the immune system to produce specific antitoxin.
Dose and Route  Primary Immunization (Series of 3 doses)
- 0.5 mL of tetanus toxoid once followed by a second
dose after 4 to 8 weeks, the third dose is given t 6 to
12 months after the second dose.
 Routine Booster Injection
- 0.5 mL IM of tetanus toxoid absorbed or 0.5 mL IM or
subcutaneously of tetanus toxoid given 10 years after
completion of primary immunization and every 10
years thereafter. If a dose is given sooner as part of
wound management, the next booster is not needed
for 10 years thereafter.
Pregnancy:
- If a pregnant woman has not previously been vaccinated, or
if her immunization status is unknown, she should receive two
(2) doses of a tetanus toxoid-containing vaccine (TT-CV) one
month apart.
 - Second dose is given at least two weeks before delivery.
Two (2) doses protect against tetanus infection for 1–3 years
in most people.
- A third dose is recommended six months after the second
dose, which should extend protection to at least five years.
- Two further doses for women who are first vaccinated
against tetanus during pregnancy should be given after the
third dose, in the two subsequent years or during two
subsequent pregnancies.
- If a woman has had 1–4 doses of a TT-CV in the past, she
should receive one dose of a TT-CV during each
subsequent pregnancy to a total of five doses (five doses
protects throughout the childbearing years).
Indication - Tetanus toxoid vaccination is recommended for all pregnant
women depending on previous tetanus vaccination exposure,
to prevent maternal and neonatal mortality from tetanus.
- Prevention against tetanus in children and adults age 7
years and older.
- Tetanus toxoid is indicated for booster injection only for
persons 7 years old of age and older against tetanus.
Contraindication - Past anaphylaxis reaction to the tetanus toxoid
- Hypersensitivity
- Febrile illness and other acute infection
- Patient with low immune response
- Patient with immunoglobulin abnormalities
- Patient with thrombocytopenia or any coagulation disorder
- Neurologic disorders
- History of febrile seizures
Side Effect/Adverse Significant: Syncope.
Effect Blood and lymphatic system disorders: Lymphadenopathy.
Gastrointestinal disorders: Nausea.
 General disorders and administration site
conditions: Injection site reactions (e.g. pain, redness,
bruising, swelling, induration), fever, malaise, irritability.
Musculoskeletal and connective tissue disorders: Arthralgia,
myalgia.
Nervous system disorders: Neuritis, headache, dizziness.
Skin and subcutaneous tissue disorders: Rash.
Vascular disorders: Hypotension.
Potentially Fatal: Anaphylactoid or hypersensitivity reactions.
Drug Interaction Some products that may interact with this vaccine are drugs
that weaken the immune system including cyclosporine,
tacrolimus, cancer chemotherapy, corticosteroids such
as prednisone, recent/planned vaccinations
(e.g., diphtheria/tetanus toxoids). Chloramphenicol,
corticosteroids, immunosuppressants may impair the
immune response to tetanus toxoid. Avoid concomitant
elective immunization.
Nursing - Observe the 12 rights in giving the medication
Responsibilities - Postpone immunization if patient has acute illnesses.
- Determine the date of last tetanus toxoid
immunization.
- Monitor vital signs
- Allow the patient to lie down to prevent vomiting
- Shake well the vial before withdrawing each dose.
- Monitor patient for hypersensitivity reactions,
seizures, and injection site reactions.
- Educate the patient to increase fluid intake to prevent
dehydration
- It isn’t known whether tetanus toxoid appears in
breast milk. Use cautiously in breast-feeding women.
- Educate patient that pain and tenderness in the
injection site may occur
- Inform patient of possible adverse reactions.
- Encourage patient to report distressing adverse
reactions.
- Instruct to avoid extraneous activities
- Although there’s no evidence of teratogenicity, it’s
recommended that administration be deferred until
second trimester.
- Tell patient that immunization requires a series of
injections. Stress the importance of keeping
scheduled appointments for subsequent doses.
- Inform the patient of the importance of completing the
immunization series, unless a contraindication to
further immunization exists.
Reference

Drugs (2020). Tetanus Toxoid (Adsorbed). Retrieved from

https://www.drugs.com/cdi/tetanus-toxoid-adsorbed.html

FDA (n.d). Tetanus Toxoid – Bio-TT. Retrieved December 2, 2020 from

https://ww2.fda.gov.ph/index.php/consumers-corner/registered-drugs-2/528377-BR-663

Global Library of Women’s Medicine (n.d). Tetanus toxoid, absorbed. Retrieved

December 2, 2020 from
https://www.glowm.com/resources/glowm/cd/pages/drugs/t017.html

Mayo Clinic (2020). Tetanus Toxoid (Intramuscular Route, Injection Route). Retrieved
December 2, 2020 from https://www.mayoclinic.org/drugs-supplements/tetanus-toxoid-
intramuscular-route-injection-route/description/drg-20066243

Omudhome, O. (2019). Tetanus Toxoid Injection (Tetanus Toxoid Absorbed) Retrieved

December 2, 2020 from https://www.medicinenet.com/tetanus_toxoid-
injection/article.htm

Rabadi, T., Brady M. (2020). Tetanus Toxoid. Retrieved December 2, 2020 from
https://www.ncbi.nlm.nih.gov/books/NBK557415/

WHO (2018). WHO recommendation on tetanus toxoid vaccination for pregnant women.
Retrieved December 9, 2020 from https://extranet.who.int/rhl/topics/preconception-
pregnancy-childbirth-and-postpartum-care/antenatal-care/who-recommendation-
tetanus-toxoid-vaccination-pregnant-women