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immune system

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<p>Natural Immunity</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Present at birth Protection provided by physical barriers: Skin, mucus membranes Phagocytic cells NK cells</p> <p>Specific Acquired Immunity</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Production of antibodies against antigens Active: Having the infection or a vaccine / toxoid Takes weeks to months to take effect Passive: Administration of preformed antibodies (immunoglobulins)</p> <p>Major Cells of the Immune SystemN203 ATI (Unit 3) Immune System -</p> <p> B cells Produce antibodies Helper T cells (CD4) </p> <p> Macrophages &amp; Dendritic Cells Phagocytosis </p> <p>Activate B cells hypersensitivity reaction</p> <p> Responsible for delayed Cytotoxic T cells (CD8) Directly destroy target cells</p> <p>MMR Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Measles, Mumps, RubellaAdverse Effects:</p> <p> Local reactions (rash, fever, swollen glands) AnaphylaxisContraindications/Precautions:</p> <p>Allergies to eggs, gelatin, and neomycin Hx of thrombocytopenia Immunocompromised individuals Recently received blood products or immunoglobulins</p> <p>Education:</p> <p>DTaP Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Diphtheria, Tetanus, PertussisAdverse Effects:</p> <p> Encephalopathy (fever, persistent crying) Seizures Local reaction at injection siteContraindications/Precautions:</p> <p>Severe febrile illness Hx of anaphylaxis Hx of encephalopathy 7 days after DTaP vaccination Occurrence of seizures with 3 days of vaccination Inconsolable crying (&gt;3 hrs) within 48 hrs of vaccination</p> <p>Education:</p> <p>Hepatitis Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Hepatitis A &amp; B virusesAdverse Effects:</p> <p> Local reaction AnaphylaxisContraindications/Precautions:</p> <p> Hx of anaphylaxis Allergy to Bakers yeastEducation:</p> <p>Varicella Virus Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Varicella zoster virus (chickenpox)Adverse Effects:</p> <p> Varicella-like rashContraindications/Precautions:</p> <p>Pregnancy Cancer Hx of allergy to neomycin or gelatin Immunocompromised patients</p> <p>Education:</p> <p> Slight risk of virus being transmitted. If child develops rash after vaccination they should be presumed to be infected and appropriate precautions taken.</p> <p>Inactivated Polio Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Immune response to poliovirusAdverse Effects:</p> <p> Vaccine-related paralytic poliomyelitis Local reactionContraindications/Precautions:</p> <p> NoneEducation:</p> <p>Influenza Vaccine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Therapeutic Uses:</p> <p> Immunity to influenza strains in the vaccineAdverse Effects:</p> <p> Guillain-Barr syndrome (ascending paralysis, weakness of BLE, dyspnea) Local reaction FeverContraindications/Precautions:</p> <p> Acute febrile illness Hypersensitivity to eggsEducation:</p> <p>Immune Globulin</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Expected Action:</p> <p>Proto: Gamma globulin (IgG)</p> <p> Passive immunityTherapeutic Uses:</p> <p> Immunodeficiency syndrome Bone marrow transplantation Measles, rubella, varicella exposureAdverse Effects:</p> <p> Chronic lymphocytic leukemia Hep A, Hep B exposure</p> <p> Local reaction / hypersensitivityContraindications/Precautions:</p> <p>Interactions:</p> <p> Live viruses can lead to disease avoid live viruses for 3 months following IgGEducation:</p> <p> Administer in deep muscle / Date of exposure must be known (6 days measles, 7 days Hep B, 14 days Hep B)</p> <p>Immunostimulants</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Expected Action: Therapeutic Uses:</p> <p>Proto: Interferon Alfa, Aldesleukin, Interleukin 2</p> <p> Enhance immune response / reduce proliferation of cancer cells Leukemia / melanoma / Kaposis sarcomaAdverse Effects:</p> <p> Flu-like symptoms / Marrow suppression, alopecia, cardiotoxicity, neurotoxicity HypotensionContraindications/Precautions:</p> <p> Hypersensitivity / pregnancy and lactation (C)Interactions:</p> <p> Theophylline (toxicity) Zidovudine or retrovir ( neutropenia) Antihypertensives ( hypotensive effect)Education:</p> <p> Refrigerate / Do not shake vial</p> <p>Immunosuppressants(General)</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Act on helper T lymphocytes to suppress proliferation of B cells and</p> <p>cytotoxic T cells For treatment of autoimmune disorders and to prevent organ rejection Rheumatoid arthritis Early type 1 diabetesAdverse Effects</p> <p> Lupus Myasthenia gravis risk of infection Tacrolimus Methotrexate </p> <p> TeratogenesisMedications:</p> <p> Cyclosporine (Gengraf, Neoral) Glucocorticoids (prednisone) Cytotoxics (azathioprine)</p> <p>Cyclosporine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Adverse Effects:</p> <p> HepatotoxicityContraindications/Precautions:</p> <p> Nephrotoxicity (BUN, Creatinine, I&amp;O)</p> <p> Pregnancy / Recent live virus vaccination / Recent contact chickenpox or herpesInteractions:</p> <p>Phenytoin, phenobarbital, rifampin, carbamazepine, TMP-SMZ ([cycl] ) Ketoconazole, erythromycin, amphotericin ([cycl] toxicity) Amphotericin, aminoglycosides, NSAIDs (all nephrotoxic renal damage) Grapefruit juice ( [cycl] by 50%) Mix oral dose milk or OJ to palatability Nursing Admin initial dose over 2-6 hours Monitor for hypersensitivity, stay pt. for 30 mins</p> <p>Glucocorticoids</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Adverse Effects:2+</p> <p>Proto: Prednisone, prednisolone</p> <p> Osteoporosis (use Ca &amp; vitamin D supplements Renal insufficiency (stop drugs immediately) Fluid retentionContraindications/Precautions:</p> <p> Systemic fungal infectionsInteractions:</p> <p> Recurring live virus vaccines</p> <p> K+-depleting diuretics ( hypokalemia) NSAIDs ( GI ulceration) Glucocorticoids (Promote hyperglycemia)Education:</p> <p>Azathioprine</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Adverse Effects:</p> <p> Bone marrow depression neutropenia &amp; thrombocytopeniaContraindications/Precautions:</p> <p> None listed in ATIInteractions:</p> <p> Allopurinol (delays inactivation of azathioprine)Education:</p> <p>Antihistamines(General)</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Action is on H1 receptors which blocks histamine releaseMedications</p> <p> 1st Generation: Diphenhydramine (Benadryl) Promethazine (Phenergan) Dimenhydrinate (Dramamine)Therapeutic Uses:</p> <p> 2nd Generation: </p> <p>Loratadine (Claritin) Cetirizine (Zyrtec) Fexofenadine (Allegra) Desloratadine (Clarinex)</p> <p> Mild allergic reactions Motion sickness</p> <p> Anaphylaxis Insomnia</p> <p>Antihistamines(1st Generation)</p> <p>N203 ATI (Unit 3) Immune System -</p> <p>Chemotherapy Agents(Medications)</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Nitrogen mustards.....................................................cyclophosphamide Platinum compounds.................................................................cisplatin Folic acid analog................................................................methotrexate Pyrimidine analog...................................................................cytarabine Purine analogs................................................................mercaptopurine Antitumor antibiotics...........................................................doxorubicin Mitotic inhibitors..................................................vincristine, paclitaxel Topoisomerase inhibitors.......................................topotecan, irinotecan Breast cancer....................................................tamoxifen (antiestrogen) Prostate cancer........................................................................leuprolide Progestins....................................................................megestrol acetate Cytotoxic medications Asparaginase Hydroxyurea Procarbazine</p> <p>Chemotherapy Agents(Side Effects)</p> <p>N203 ATI (Unit 3) Immune System -</p> <p> Bone marrow suppression GI discomfort Alopecia Mucositis</p> <p> Avoid crowds, check for bleeding gums</p> <p> Give antiemetic (ondansetron) with dexamethasone, metoclopramide or granisetron at outset</p> <p> Occur 7-10 days after, persist max of 2 months after Frequent oral care, soft toothbrush, EtOH mouthwash Sperm banking, Avoid gravid on meds. fluids, I&amp;O Give allopurinol if uric acid</p> <p> Reproductive toxicity</p> <p> Hyperuricemia or uric acid</p> <p> Extravasation of vesicants such as carmustine, dactinomycin,</p> <p>daunorubicin, and vincristine</p>