Chapter 49 Flashcards
Antigens (foreign proteins)
from an invading organism; specific information is imprinted into a cellular “memory bank” of the immune system; the body can then effectively fight any future invasion by that same organism by mounting an immune response
Antibodies
immunoglobulin molecules that have antigen-specific amino acid sequences
Immunoglobulins
- glycoprotein molecules synthesized by the humoral immune system for the purpose of destroying all substances that the body recognizes as foreign
- concentrated preparation containing predominantly immunoglobulin G and is harvested from a large pool of blood donors
Artificial Active immunization
- The body is exposed to a relatively harmless form of an antigen.
- The immune system is stimulated and “remembers” this antigen if subsequent exposures occur.
- Does not cause a full-blown infection
Natural Active Immunization
person acquires immunity by surviving the disease itself and producing antibodies to the disease-causing organism
Artificial passive immunization
- administration of serum or concentrated immunoglobulins
- The inoculated person is given the substance needed to fight off the invading microorganism.
- This type of immunization bypasses the host’s immune system.
- Example: immunization with tetanus immunoglobulin, hepatitis immunoglobulin, rabies immunoglobulin, and snakebite antivenin
Natural passive immunization
-antibodies are transferred from the mother to her infant in breast milk or through the bloodstream via the placenta during pregnancy
Biological Antimicrobial Drugs
- Also called biologicals
- Antitoxins
- Antisera
- Toxoids and vaccines (immunizing biologicals)
- Used to prevent, treat, or cure infectious diseases
- Toxoids and vaccines are known as immunizing biologics, and they target a particular infectious microorganism.
Toxoids
- Antigenic (foreign) preparations of bacterial exotoxins
- Detoxified with chemicals or heat
- Weakened or “attenuated”
- Cannot revert back to a toxic form
- Stimulate one’s immune system to produce a specific antibody
- Artificial active immune response
- These antibodies protect against future exposures.
- Example: diphtheria and tetanus caused by toxin-producing bacteria
Vaccines
- Suspensions of live, attenuated (weakened) or killed (inactivated) microorganisms
- These slight alterations in the bacteria and viruses prevent the person injected from contracting the disease
- Also stimulate the production of antigens against a -specific antibody
- Vaccinations with live bacteria or virus provide lifelong immunity.
- Vaccinations with killed bacteria or virus provide partial immunity, and booster shots are needed periodically.
- Example: influenza and pneumonia vaccines
Antibody Titer
- Measure of how many antibodies to a given antigen are present in the blood and is used to assess whether enough antibodies are present to protect the body effectively against the particular pathogen
- Sometimes the antibody levels decline over time.
- Booster shot: another dose of the vaccine is given to restore the antibody titers to a level that can protect the person against the infection
Passive Immunization
- Serum or concentrated immunoglobulins from humans or animals are injected into a person.
- The substances needed to fight off invading microorganisms are given directly to a person.
- The immune system is bypassed
- Short-lived compared with active immunization but works faster
- Passive immunization lasts only until the injected immunoglobulins are removed from the person’s immune system by the reticuloendothelial system.
Antitoxins
purified antiserum that is usually obtained from horses inoculated with the toxin
Passive Immunizing Drugs: Examples
-Antivenins
Pit viper, coral snake
Black widow spider
-Hepatitis B immune globulin
-Immunoglobulin, various forms
-Rabies immunoglobulin (human)
-Rho(D) immune globulin (RhoGAM)
-Tetanus immunoglobulin
-Varicella-zoster immunoglobulinActive Immunization Indications
- Prevents infection caused by bacterial toxins or viruses
- Provides long-lasting or permanent immunity
- “Herd immunity”
Passive Immunization Indications
- Antitoxins, antivenins, immunoglobulins
- Minimizes effects of poisoning by the venoms of spiders and certain snakes
- Provides quick immunity before a person’s own immune system has a chance to make antibodies (such as in cases of exposure to hepatitis B or rabies viruses)
Active Immunizing Drugs
- Diphtheria and tetanus toxoids and acellular pertussis vaccine (adsorbed)
- Haemophilus influenzae type b conjugate vaccine
Influenza Vaccine
- Needs to be given each year before the influenza season begins
- Single most important influenza control measure
- FluMist is given intranasally, whereas the others are given intramuscularly.
- CDC: all people older than 6 months of age should receive the influenza vaccine.
- Newer formulations of the influenza vaccine: “high-dose” Fluzone, which is specifically indicated for older adults
Passive Immunizing Drugs
- Hepatitis B immunoglobulin
- Immunoglobulin
- Rh0(D) immunoglobulin
- Rabies immunoglobulin
- Tetanus immunoglobulin
- Varicella-zoster immunoglobulin
Minor adverse effects
Fever, minor rash, soreness at injection site, itching, adenopathy
Severe adverse effects
Fever higher than 103° F, encephalitis, convulsions, anaphylactic reaction, dyspnea, others
Minor reactions
Treated with acetaminophen and rest
Serious or unusual reactions
- Serum sickness
- Report serious or unusual reactions to the Vaccine Adverse Event Reporting System (VAERS)
Nursing Implications
- Assess previous reactions and responses to immunizations.
- Assess for contraindications, including immunosuppression
- Before giving any drug, recheck the specific protocols for administration and schedules for administration.
- Encourage parents of young children to keep a journal of the child’s immunization status, with dates of immunizations and reactions, if any.
- If discomfort occurs at the injection site, apply warm compresses and give acetaminophen.
- Do not give aspirin to children
