N368 Final Immunmodulators and Antibiotics Flashcards
immunomodulator
can increase or decrease the immune system
ex have transplanted organ to prevent resistance you would use
immunomodulator
Immunoglobulins
passive immunity; antibody
immunostimulants
interferon - stimulates body defenses so that microbes or cancer cells can be more effectively attacked
immunosuppressant
suppress body defenses to prevent transplanted organ from being rejected *glucocorticoid *antibodies antimetablites *calcineric
nonspecific body defense
called innate defense
barrier to microbes
GENERAL RESPONSES THAT ARE NOT SPECIFIC TO A PARTICULAR THREAT - EX PHAGOCYTE, NATURAL KILLERS
kinin system
releases cytokine to provide antiviral property
Second line of defense in body
IMMUNE RESPONSE
*B cell and T cell
B cell are initially _____
- immunocomputent
* mature when specific to an antigen
plasma cell is a ________ B cell
mature B cell
plasma cells produce what TWO things?
IMMUNOGLOBULINGS - IgM, IgG, IgE, IgA
Initially will have IgM
then as recovering you will have IgE
IgA found in secretion glands
Also produces MEMORY CELLS
MEMORY CELLS DO WHAT?
TAKES 10 DAYS MAKING ENOUGH IgM and IgG normally, but the memory cells allow for an acceleration of this
Can only be activated if exposed to the particular programmed antigen
Booster shots are necessary for?
because overtime memory cell numbers decrease, vaccine schedules usually requires 4 shots
T cells
- HELPER T Cell: activates other T cells and communicates with B cells
- Cytotoxic Te Cells: travel through body killing pathogens and cancer
- Suppressor T cell
- Memory T cell
Why is HIV so problematic?
because it targets helper T cells
Suppressor T cell
down regulate antibody for self antigen; so your body does not attack itself
Cytokines do what to macrophages
enhance killing power of macrophage
Active immunity requires?
- exposure to antigen
- Attenuated or inactivate antigen for vaccine then the human will make antibody specific to the antigen; this first exposure makes memory cells for the antigen to help boost antibody production faster when exposed to pathogen.
Passive Immunity is obtained
when breast fed getting IgA passively which is an antibody and not the antigen, so cannot make memory cells
or when artificially it fades within 4-6 months USED FOR IMMUNOSUPPRESSED PEOPLE
CMV, HepB, RhGAM (baby and mother difference), Tetanus, Rabies are examples of diseases that need what pharmacologic intervention.
immunoglobulins
Passive immunity
only good for 4-6 months
MMR is an example of what type of vaccine
Active
inactivated vaccine examples
polio
influenza
HepA
HibTITER requires how many shots?
4 series
HepB vaccine
Recombivax HD, 3 Shots
MMR is a live vaccine and requires how many shots
2 shots at 15 months and age 4-6
Poliovirus
inactivated (IPOL) 4th does is final should be after 4th birthday
Influenza vaccine during the first requires what which is unusual when compared to adults?
two shots
hepatitis B schedule
schedule birth 2 months and 6 months
interferon and prototype drugs
goes to the neighboring uninfected cells and signal them to secrete antiviral protein
a. interferon alpha 2a
b. interferon beta
c. interleukins
interferon alpha Tx requires what schedules
3x/wk can be used to treat cancers, non-hodgkins, or malignant melanoma
AE - hepatoxicity
immunosuppressant you want to give
to transplant patients
Transplant rejection often occurs because
cell-mediated response T-cells usually takes a few months
an acute response then it is not coming from T cells
Glucocorticoids
anti-inflammatory responses suppress histamine and prostaglandins
can inhibit immune system to reduce inflammation
Primarily used short term 4-10 days, ex prednisone
Long term treatment: if someone has an inflammatory disease then give low doses some doctors ALTERNATE DOSES small one day larger the next
Prednisone
AE - **cushings syndrome** with long term use, hyperglycemia and easily bruise; **mood changes**; **osteoporosis** Long term (and sometime short term) therapy very important to taper the PT down otherwise the adrenal cortex will not be ready because it is not making it due to negative feedback. Addison disease if don't taper (cortisol insufficiency)
antibodies drugs
to provide passive immunity
Targets human T-cell
Antimetabolites
ex: cytoxan, Rheumatrex
AE bone marrow suppression
calcineurin inhibitors
HTN, hepatoxicity, and nephrotoxicity (must monitor this)
cyclosporin lab values to check
assess for serum creatinine (due to renal insufficiency)
Pathogens include
bacteria, virus, fungi, or multicellular organisms
what do you have to use to fight fungal infections
antifungal
to cause infection pathogens must bypass
first and second lines
Virulence
potency of virus; disease producing potential
in small numbers can cause disease then highly virulent
two ways cause disease
invasiveness
toxin production
basic shapes of bacteria
bacilli
cocci
spirilla
gram positive
THICK CELL WALL, stain shows purple color
ex bacteria: staphylococci, streptococci, entercocci
anti-infective drugs
antibacterial, antimicrobic, and antiviral
if a drug destroys bacteria then we call it
bacterialcidal
if the drug growth of bacteria then we call it
bacteriostatic
Major pharmacological classification of antibiotics
7 major: penicillin cephallosporin aminoglycoside - protein synthesis inhibitor macrolide tetracycline fluoroquinolone
mechanisms of action of antibiotics
cell-wall inhibitor, protein synthesis inhibitor, folic acid inhibitor
penicillin
cell wall inhibitor
gram positive bacteria
Tx syphillis/gonorrhea
Cephalosporin
cell wall inhibitor: gram positive and gram negative
aminoglycoside
protein synthesis inhibitor
Gram negative aerobics
macrolide high dose
protein synthesis
gram positive and negative
fluoroquiniolone
DNA synth inhibitor
Gram positive and negative
sulfaonamidea
anti-metabolites, especially inhibits folic acid
Bacteriostatic
Tetracycline: protein synthesis inhibitor; G (+) G(-); Tx for chlamydia
Macrolide low dose: protein synthesis inhibitor; G(+) and G(-)
penicillin AE
diarrhea, nausea, vomitting
three major beta-lactamase inhibitors
Clavulanate
Sulbactam
Tazobactam
Cephalosporin drugs
inhibit bacterial cell-wall synthesis
Primary use: both gram positive as well as gram-negative organisms for serious infections of lower respiratory tract, central nervous system, genitourinary system (gonorrhea treatment), bones, blood, and joints
Prototype drug: cefotaxime (Claforan)
Adverse effects: hypersensitivity, anaphylaxis, diarrhea, vomiting, nausea, pain at injection site, pseudomonas colitis, nephrotoxicity
Contraindication: who experiencing allergy reaction to PCN
