Needle-stick Guideline Medication

Updated: Jul 01, 2021
  • Author: Megan A Stobart-Gallagher, DO; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Medication Summary

When indicated, medications are used to prevent disease transmission.



Class Summary

Vaccines containing epitopes that can elicit an immune response are very effective in inducing a protective response.

Diphtheria & tetanus toxoids (Tenivac)

Used to induce active immunity against tetanus in selected patients. The immunizing agent of choice for most adults and children < 7 y are tetanus and diphtheria toxoids. Necessary to administer booster doses to maintain tetanus immunity throughout life.

Pregnant women should receive only tetanus toxoid, not a diphtheria antigen-containing product.

May administer into deltoid or midlateral thigh muscles in children and adults. Preferred site of administration in infants is the mid-thigh laterally.

Tetanus immune globulin (HyperTET S/D)

Used for passive immunization of any person with a wound that might be contaminated with tetanus spores. Administer if immunization status is unclear or patient is allergic to diphtheria/tetanus vaccine.

Hepatitis B vaccine (Recombivax HB, Engerix-B)

Recombinant vaccine used to provide immunization against all known subtypes of hepatitis B virus.


Nucleoside reverse transcriptase inhibitors

Class Summary

Nucleoside reverse transcriptase inhibitors inhibit the enzyme that allows for reproduction of the virus. Therefore, these drugs work to prevent viral replication.

Tenofovir DF (Viread)

Tenofovir is an antiretroviral agent used in the treatment of acquired immunodeficiency syndrome (AIDS). It inhibits the activity of HIV reverse transcriptase by competing with the natural substrate deoxyadenosine 5’-triphosphate and, after incorporation into DNA, by DNA chain termination

Common side effects include nausea, vomiting, diarrhea, and asthenia, but can have more significant effects, leading to hepatotoxicity or renal failure.

Emtricitabine (Emtriva)

Emtricitabine is a synthetic nucleoside cytosine analogue. It competes with deoxycytidine-5’-triphosphate and is incorporated into viral DNA, causing chain termination.

Significant side effects are rare, other than GI upset. Can cause lactic acidosis. Manufactured as a combination pill with tenofovir and marketed as Truvada.


Antiretroviral Agents, Integrase Inhibitor

Class Summary

These agents prevent insertion of a DNA copy of the viral genome into host cell DNA. They are indicated for HIV-1 infection combination therapy in treatment-experienced adults with evidence of viral replication and drug-resistant HIV-1 strains.

Raltegravir (Isentress)

Raltegravir prevents integration of the proviral gene into human DNA by inhibiting the catalytic activity of integrase.

Dolutegravir (Tivicay)

Inhibits the strand transfer step of HIV-1 integration necessary for the HIV replication cycle by binding to the integrase active site.