You'll see changes in recommendations for using antivirals and vaccines for the current flu season.
About 97% of the influenza A viruses circulating now are the novel H1N1 (swine) flu. In fact, CDC now just calls it 2009 H1N1 flu.
Treatment. Antivirals aren't recommended for most patients this year. Most people don't need them and widespread use leads to resistance.
Save treatment for patients with severe illness or those at higher risk for complications...children under 2, pregnant women, the elderly, and people with asthma or other chronic conditions.
Recommend EITHER oseltamivir (Tamiflu) or zanamivir (Relenza).
Watch for this to change to Relenza...OR Tamiflu PLUS rimantadine or amantadine...if Tamiflu-resistant strains begin to circulate.
If Tamiflu suspension isn't available, you can compound it from the capsules. Get instructions from our Detail-Document.
Prophylaxis. Discourage using antivirals for prophylaxis.
Instead, recommend "watchful waiting" after exposure...and starting treatment only if flu symptoms occur in high-risk people.
H1N1 vaccine. Register with your state or local health department to get the new vaccine. It will be provided to you at no cost...and you can charge an administration fee in most cases.
One dose will be enough for people age 10 and up...younger kids should get two doses given 3 to 4 weeks apart.
Recommend the first vaccinations go to people at highest risk...pregnant women, people in close contact with infants under 6 months, health care workers, people 6 months to 24 years, and those 25 to 64 with chronic conditions.
Next add everyone else ages 25 to 64...and last, people over 65. Explain to older people that they have an advantage...they were likely exposed to a somewhat similar virus that circulated when they were young. Therefore seniors seem to have a lower risk of getting this year's H1N1.
Seasonal flu vaccine. Encourage people to get this now because seasonal strains can pop up at any time. Reassure patients that protection from just ONE shot will last the whole flu season.
To be able to answer questions, get our new CE, 2009 H1N1 Recommendations, for $9.50 for subscribers. Also get any Pharmacist Immunization CE to meet requirements in any state from PL CE Organizer.
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