Immune System Agents Flashcards
Focal infection
the root infection of the systemic infection (a dental abscess could be the focal infection of bacterial endocarditis that leads to multi-organ failure/sepsis)
Primary and Secondary Infections
A primary infection can weaken a body so that a second infection caused by a different organism can invade
Super infection
a secondary infection caused because of the action of an antimicrobial that has wiped out/weakened the normal flora that normally keeps the invading organism in check
Incubation stage of Infectious Disease
- infected patient is unaware of it
- length of time the illness signs/symptoms varies by organism and immune system of host as well as external/internal stresses to host.
- infection can be spread
Prodromal period of infectious disease
- short interval preceding the infectious disease
- patient feels ill or like they are “coming down with something”
- is caused, in part, by the rapid response by the immune system. (going into inflammatory phase)
Illness phase of infectious disease
- incline of illness (time of greatest s&s specific to the pathogen
- decline of illness (patient has turned the corner in terms of s&s
Convalescence stage of infectious disease
- pathogen replication has stopped and pathogens are dying off or becoming inactive
- body is regaining its pre-illness strength
Pathogens we encounter and how we treat them
- Bacteria (antibacterials; vaccines)
- Viruses (antivirals; antiretrovirals; antiyeasts)
- Fungi (antifungals; antiyeasts)
- Protozoa and malaria parasites (antimalarials; some antibiotics)
- GI parasites (antihelminths)
Pharmacological responses must be…
to utilize body’s defenses or temper a normal biological response.
- immune system can be stimulated or depressed
Acquired immunity
active: exposure to antigen or antigenic proteins (vaccines) - population health perspective and vaccinations (herd immunity)
passive: antibody injection, gamma globulin (a substance made from the human blood plasma)
Allergies
Antihistamines and allergy desensitization
Autoimmune (hyper-immune responses)
- immune suppressant drugs (prednisone, DMARDs, cyclosporine)
Fever Response
antipyretics
Prototype Drug-vaccines
hepatitis B vaccine
Mechanism of Action - hep B vaccine
vaccine, to provide active immunity
Primary use: hep b vaccine
individuals who are at risk of exposure to hep B virus
Adverse effects of hep b vaccine
pain and inflammation at injection site, transient fever or fatigue, potential for hypersensitivity
Adverse effects of hep b vaccine
pain and inflammation at injection site, transient fever or fatigue, potential for hypersensitivity
Prototype Drug: immunostimulant - Interferon
interferon alpha-2a (Intron A)
Mechanism of action: interferon
enhances or stimulates immune system to remove antigens, suppress growth of cancer cells, antiviral activity
Primary use of interferon
to remove hair-cell leukemia, chronic hepatitis C infection, or malignant melanoma
Adverse effects: interferon
flu-like symptoms, also nausea, vomiting, diarrhea, anorexia, headache, dizziness, fever
Immune Globulin
- immune globulin is antibody specific to an antigen
- source is from donated human blood
- immunoglobulin is available for Hep A and B, measles, rabies, Rhesus factor, tetanus, varicella, cytomegalovirus
Immunosuppressants
- inhibit client’s immune system
- used for patients with severe autoimmune disease when the body has hyperactive immune response. or used to prevent tissue rejection following transplant
- toxic to bone marrow (low blood cell count, fatigue, less oxygen carrying capacity, cyanosis)
greatest risk when administering immunosuprressant
- infection, decreased WBC, RBC, and platelet
greatest risk when administering immunosuprressant
- infection, decreased WBC, RBC, and platelet
Prototype Drug: Immunosuppressant
Cyclosporine (Neoral, Sandimmune)
Mechanism of action: cyclosporine
to inhibit helper T cells
Primary use: cyclosporine
for transplant recipients
Adverse effects: cyclosporine
75% of patients experience reduction in urine flow. Infections, tremor, hypertension, elevated hepatic enzymes
Nonsteroidal anti-inflammatory drugs
are the primary drugs for the treatment of mild to moderate inflammation
- block inflammation by inhibiting cyclooxygenase, the key enzyme in the biosynthesis of prostaglandins (which promote inflammation)
Anti-Inflammatory Drugs - NSAIDS
- prototype
Ibuprofen (advil, motrin)
Mechanism of action: ibuprofen
inhibit prostaglandin synthesis
Primary use: ibuprofen
for musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis, mild to moderate pain, reduction in fever, dysmenorrhea
Pharmacological Management: NSAIDS
- obtain baseline kidney-and-liver-function tests, CBC
- monitor bleeding time with long-term administration
- assess for changes in pain, reduction in temperature and inflammation
- assess for gastrointestinal bleeding, hepatitis, nephrotoxicity, hemolytic anemia
- Use NSAIDs cautiously in elderly clients - potential increased bleeding
- Aspirin is contraindicated in pediatric clients
Adverse side effects: ibuprofen
- Adverse effects: nausea, heartburn, GI bleeding, dizziness
Systemic Glucocorticoids
- anti-inflammatory drugs that can suppress severe cases of inflammation
- suppress histamine release
- inhibit synthesis of prostaglandins
- suppress certain functions of phagocytes and lymphocytes.
Glucocorticoid Prototype Drug:
Prednisone
mechanism of action: prednisone
synthetic glucocorticoid, suppresses histamine
Primary use: prednisone
treat inflammation
Adverse effects: prednisone
cushing’s syndrome.
increase risk of infection
GI: pain, ulcers, bleeds
Antipyretics prototype Drug: mechanism of action: primary use; adverse effects: dosage:
- acetaminophen
- to reduce fever by direct action at level of hypothalamus and dilation of peripheral blood vessels (enables sweating)
- to relieve pain an reduce fever (not an anti-inflammatory)
- possible liver damage, less gastric irritation
- max 4000 mg in 24 hr
