Natural Immunity

N203 ATI (Unit 3) Immune System -

 Present at birth Protection provided by physical barriers: Skin, mucus membranes Phagocytic cells NK cells

Specific Acquired Immunity

N203 ATI (Unit 3) Immune System -

 Production of antibodies against antigens Active: Having the infection or a vaccine / to oid !akes "eeks to months to take effect Passive: Administration of preformed antibodies #immunoglobulins$

Maj r !ells f t"e Immune System

N203 ATI (Unit 3) Immune System -

 % cells Produce antibodies Helper ! cells #)(*$

&acrophages ' (endritic )ells Phagocytosis

Activate % cells hypersensitivity reaction

+esponsible for delayed )ytoto ic ! cells #)(,$ (irectly destroy target cells

MM# $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

&easles, &umps, +ubella

Adverse Effects:

-ocal reactions #rash, fever, s"ollen glands$ Anaphyla is

Contraindications/Precautions:

Allergies to eggs, gelatin, and neomycin H of thrombocytopenia .mmunocompromised individuals +ecently received blood products or immunoglobulins

Education:

%Ta& $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

(iphtheria, !etanus, Pertussis

Adverse Effects:

/ncephalopathy #fever, persistent crying$ Sei0ures -ocal reaction at in1ection site

Contraindications/Precautions:

Severe febrile illness H of anaphyla is H of encephalopathy 2 days after (!aP vaccination 3ccurrence of sei0ures "ith 4 days of vaccination .nconsolable crying #54 hrs$ "ithin *, hrs of vaccination

Education:

'epatitis $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

Hepatitis A ' % viruses

Adverse Effects:

-ocal reaction Anaphyla is

Contraindications/Precautions:

H of anaphyla is Allergy to %aker6s yeast

Education:

$aricella $irus $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

7aricella 0oster virus #chickenpo $

Adverse Effects:

7aricella8like rash
Contraindications/Precautions:

Pregnancy )ancer H of allergy to neomycin or gelatin .mmunocompromised patients

Education:

Slight risk of virus being transmitted9 .f child develops rash after vaccination they should be presumed to be infected and appropriate precautions taken9

Inacti(ated & li $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

.mmune response to poliovirus

Adverse Effects:

7accine8related paralytic poliomyelitis -ocal reaction

Contraindications/Precautions:

None
Education:

Influen)a $accine

N203 ATI (Unit 3) Immune System -

Therapeutic Uses:

.mmunity to influen0a strains in the vaccine

Adverse Effects:

:uillain8%arr; syndrome #ascending paralysis, "eakness of %-/, dyspnea$ -ocal reaction <ever
Contraindications/Precautions:

Acute febrile illness Hypersensitivity to eggs

Education:

Immune *l +ulin

N203 ATI (Unit 3) Immune System -

Expected Action:

Proto: :amma globulin #.g:$

Passive immunity
Therapeutic Uses:

.mmunodeficiency syndrome %one marro" transplantation &easles, rubella, varicella e posure

Adverse Effects:

)hronic lymphocytic leukemia Hep A, Hep % e posure

-ocal reaction / hypersensitivity

Contraindications/Precautions:

Interactions:

-ive viruses can lead to disease = avoid live viruses for 4 months follo"ing .g:
Education:

Administer in deep muscle / (ate of e posure must be kno"n #> days measles, 2 days Hep %, ?* days Hep %$

Immun stimulants

N203 ATI (Unit 3) Immune System -

Expected Action:

Proto: .nterferon Alfa, Aldesleukin, .nterleukin @

/nhance immune response / reduce proliferation of cancer cells

Therapeutic Uses:

-eukemia / melanoma / Kaposi6s sarcoma

Adverse Effects:

<lu8like symptoms / &arro" suppression, alopecia, cardioto icity, neuroto icity Hypotension
Contraindications/Precautions:

Hypersensitivity / pregnancy and lactation #)$

Interactions:

!heophylline #to icity$ Aidovudine or retrovir # neutropenia$ Antihypertensives # hypotensive effect$

Education:

+efrigerate / (o not shake vial

Immun suppressants
(*eneral)

N203 ATI (Unit 3) Immune System -

 Act on helper ! lymphocytes to suppress proliferation of % cells and

cytoto ic ! cells
<or treatment of autoimmune disorders and to prevent organ re1ection +heumatoid arthritis /arly type ? diabetes
Adverse Effects

-upus &yasthenia gravis risk of infection !acrolimus &ethotre ate

!eratogenesis
Medications:

)yclosporine #:engraf, Neoral$ :lucocorticoids #prednisone$ )ytoto ics #a0athioprine$

!ycl sp rine

N203 ATI (Unit 3) Immune System -

Adverse Effects:

Hepatoto icity
Contraindications/Precautions:

Nephroto icity #%BN, )reatinine, .'3$

Pregnancy / +ecent live virus vaccination / +ecent contact C chickenpo or herpes

Interactions:

Phenytoin, phenobarbital, rifampin, carbama0epine, !&P8S&A #DcyclE $ Ketocona0ole, erythromycin, amphotericin #DcyclE to icity$ Amphotericin, aminoglycosides, NSA.(s #all nephroto ic renal damage$ :rapefruit 1uice # DcyclE by FGH$ &i oral dose C milk or 3I to palatability Nursing Admin initial dose over @8> hours &onitor for hypersensitivity, stay C pt9 for 4G mins

*luc c rtic ids

N203 ATI (Unit 3) Immune System -

Adverse Effects:

Proto: Prednisone, prednisolone

3steoporosis #use )a@J' vitamin ( supplements +enal insufficiency #stop drugs immediately$ <luid retention
Contraindications/Precautions:

Systemic fungal infections

Interactions:

+ecurring live virus vaccines

KJ8depleting diuretics # hypokalemia$ NSA.(s # :. ulceration$ :lucocorticoids #Promote hyperglycemia$

Education:

A)at"i prine

N203 ATI (Unit 3) Immune System -

Adverse Effects:

%one marro" depression neutropenia ' thrombocytopenia

Contraindications/Precautions:

None listed in A!.

Interactions:

Allopurinol #delays inactivation of a0athioprine$

Education:

Anti"istamines
(*eneral)

N203 ATI (Unit 3) Immune System -

 Action is on H? receptors "hich blocks histamine release

Medications

?st :eneration: (iphenhydramine #%enadryl$ Prometha0ine #Phenergan$ (imenhydrinate #(ramamine$

Therapeutic Uses:

@nd :eneration:

-oratadine #)laritin$ )etiri0ine #Ayrtec$ <e ofenadine #Allegra$ (esloratadine #)larine $

&ild allergic reactions &otion sickness

Anaphyla is .nsomnia

Anti"istamines
(,st *enerati n)

N203 ATI (Unit 3) Immune System -

!"em t"erapy A-ents

(Medicati ns)

N203 ATI (Unit 3) Immune System -

 Nitrogen mustards99999999999999999999999999999999999999999999999999999cyclophosphamide Platinum compounds99999999999999999999999999999999999999999999999999999999999999999cisplatin <olic acid analog9999999999999999999999999999999999999999999999999999999999999999methotre ate Pyrimidine analog9999999999999999999999999999999999999999999999999999999999999999999cytarabine Purine analogs9999999999999999999999999999999999999999999999999999999999999999mercaptopurine Antitumor antibiotics99999999999999999999999999999999999999999999999999999999999do orubicin &itotic inhibitors99999999999999999999999999999999999999999999999999vincristine, paclita el !opoisomerase inhibitors999999999999999999999999999999999999999topotecan, irinotecan %reast cancer9999999999999999999999999999999999999999999999999999tamo ifen #antiestrogen$ Prostate cancer999999999999999999999999999999999999999999999999999999999999999999999999leuprolide Progestins99999999999999999999999999999999999999999999999999999999999999999999megestrol acetate )ytoto ic medications Asparaginase Hydro yurea Procarba0ine

!"em t"erapy A-ents

(Side .ffects)

N203 ATI (Unit 3) Immune System -

 %one marro" suppression :. discomfort Alopecia &ucositis

Avoid cro"ds, check for bleeding gums

:ive antiemetic #ondansetron$ "ith de amethasone, metoclopramide or granisetron at outset

3ccur 28?G days after, persist ma of @ months after <reKuent oral care, soft toothbrush, /t3H mouth"ash Sperm banking, Avoid gravid on meds9 fluids, .'3 :ive allopurinol if uric acid

+eproductive to icity

Hyperuricemia or uric acid

/ travasation of vesicants such as carmustine, dactinomycin,

daunorubicin, and vincristine