DRUGS & THE

IMMUNE SYSTEM

(CHAP 32)

THE IMMUNE SYSTEM

Through a mounted defense the body will

attempt to protect itself from foreign agents.

This defense is called immunity

Specific immunity -protection from a specific

foreign substance

Nonspecific immunity- the body need not

recognize the foreign substance

What is an antigen? It is an allergen.

Think of them as the little enemies.

Pollen

Mold spores

Animal dander

Foods

They stimulate the production

of antibodies and that are capable

of reacting specifically with antibodies

What are antibodies? Think of them as friends.

A substance that reacts with a specific antigen in an attempt to inactivate it.

What happens when the antigen enters the body

An antigen entering the body will cause an

immunological effect. An allergic reaction ! (Mucous

membranes in nose, throat & airways become inflamed)

WHAT happens when the antibodies meet up with

the antigens?

Cellular War!

Defensive maneuvers!

LINES OF DEFENSE

1. Mechanical & Chemical barriers & Reflexes (non-specific)

2. Cellular activity (nonspecific)

3. B Cells & T Cell Activity- (specific)

ACQUIRED IMMUNITY

Obtained in one’s life time-

developed after birth.

Can be acquired either naturally

or artificially as well as actively

or passively.

NATURALLY ACQUIRED

IMMUNITY

ACTIVE

Host involved

Contact with a disease

Antibody reaction

Usually long-lasting

PASSIVE

Antibodies from outside

source

Mother to fetus

Protect about 6 mo.

ARTIFICALLY ACQUIRED IMMUNITY

ACTIVE

Attenuated vaccine

Preventive measure

Force host to manufacture antibodies

PASSIVE

Immune serum or antiserum, gamma globulins

Ready made antibodies

Short lived

Used in emergencies

Derived from animals/DNA synthesis

Risky

WHICH TYPE OF IMMUNITY?

Person become ill with disease, manufactures antibodies, immunity lasts.

WHICH TYPE OF IMMUNITY?

Person is vaccinated or inoculated. Person produces own antibodies, immunity lasts for months or years

1) Survivor of an antigen e.g. Ebola virus

Example 2

2) They form antibodies again the disease

Injected into person

Serum is removed

Infant receives IgA antibodies from mother’s breast milk.

VACCINES

Biological agents used to stimulate the immune system

May be a suspension of attenuated (weakened) or killed microorganisms, or a bacterial toxoid

Review page 449 CAN & DO PROTECT US AGAINST

MANY DISEASES

WHY DO WE VACCINATE?

Administered to induce an immune response thus causes an active immunity to infectious diseases

Immune response may take several weeks or months to occur

Ideally a person will have the vaccine, then at a later time when he/she is exposed to the microorganism, his/her body will produce adequate antibodies to fight the invader.

IMMUNITY

Again, Immunity is a term used to indicate a person has adequate antibody production to fight against an invader

Immunity is measured by doing a titer. A titer is a simple blood test that measures the amount of antibodies present.

COMMON SIDE EFFECTS OF

VACCINES

REDNESS & DISCOMFORT AT

INJECTION SITE

FEVER

CHILD MAY BE FUSSY

UNCOMMON S.E.

OCCASIONALLY, ANAPHYLAXIS

VACCINES FOR COMMON CHILDHOOD

ILLNESSES

DPT

POLIO

VARICELLA (CHICKENPOX)

MMR

HEPATITIS B

HAEMOPHILUS INFLUENZA

FOR RECOMMENDED SCHEDULE, SEE TEXTBOOK

ROLE OF THE NURSE

THOROUGH ASSESSMENT

CAREFUL, CONSCIENTIOUS MONITORING OF CLIENT’S CONDITION, INCLUDING FOR NAUSEA/VOMITING (THESE DRUGS ACT ON FAST-GROWING CELLS)

CLIENT EDUCATION R/T PRESCRIBED DRUG REGIMEN

Educate client to practice birth control for 3 months after administration of vaccines.

IMMUNOGLOBUINS When plasma cells are exposed to a foreign substance,

or antigen, they have the unique ability to create and

excrete antibodies, or immunoglobulins, to help the

body fight off infection.

Immunoglobulins are proteins made up of heavy chains

(G,A,M,D or E) and light chains (kappa or lambda).

Immunoglobulins are named for their type of “heavy

chain:” IgG, IgA, IgM, IgD, and IgE.

Each immunoglobulin has a separte duty

e.g. IgA found primarily in exocrine glands- so will be

in tears, milk, gastric juices- helping to fight off infection

in these areas.

IMMUNOGLOBUINS Passive immunity

Usually given in emergency

Given when patient has already been exposed to

a virulent pathogen or is at very high risk to

exposure

Examples: Antivenins for snakebites

Sera to tx botulism, tetanus and rabies

Human varicella-zoster Ig- (HVIG)

--for chicken pox exposure

Protection only last up to 6weeks- because no memory

cells were produced.

IMMUNOSTIMULANTS AKA: BRMS (BIOLOGIC RESPONSE MODIFIERS)

ONLY A FEW ARE AVAILABLE

INTERFERONS are small proteins released by

cells when infected with a virus.

Have antiviral, anticancer and anti-

inflammatory properties and prevent

replication and multiplication

INTERLEUKINS- enhance the capabilities of the

immune system by stimulating increase T and B

cell activity

Have anticancer properties

REVIEW!!!!

QUICK REVIEW

1. Which Cell- T or B produces antibodies?

2. Why are immunoglobulins given?

3. What does Interferon ( a cytokine) do when

secreted by the infected cells?

4. What is an antigen?

5. What are some common side effects of vaccines?

6. What will be given to a person to provide

passive immunity- when a person has been

exposed to a pathogen?

IMMUNOSUPPRESSANTS

DRUGS USED TO SUPPRESS IMMUNE

SYSTEM

USED FOR PATIENTS WHO ARE

TRANSPLANT RECIPIENTS

ALSO USED FOR PERSONS WITH

SEVERE CASES OF INFLAMMATORY

DISEASE

ORGAN TISSUE

TRANSPLANTATION

“REJECTION SYNDROME” --launched attack!

TISSUE TYPING: INVOLVED PROCESS

SUPPRESSION OF THE IMMUNE SYSTEM

with IMMUNOSUPPRESSANTS

MANY HAVE SIGNIFICANT SIDE EFFECTS

DRUGS USED AS

IMMUNOSUPPRESSANTS

o ALL THESE MEDS SUPPRESS SOME ASPECT

OF THE IMMUNE RESPONSE OR T-CELL

FUNCTION

o GLUCOCORTICOIDS

o ANTIBODIES

o ANTIMETABOLITES

o CALCINEURIN INHIBITORS

NURSE’S ROLE IN

IMMUNOSUPPRESSANT

THERAPY

Thorough Assessment, Including

Complete Past History

Careful Monitoring, Including: Vital

Signs, Signs Of Infection, Degree Of Bone

Marrow Suppression

Very Important-- TEACH TO AVOID

INFECTIONS, PERSONS WITH URI’s,

ETC.