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Immunosuppressant & Immunizing Drugs
Terms in this set (23)
Purpose of the immune system
The purpose of the immune system is to distinguish self from non-self and to protect the body from foreign material (antigens), including cancer.
-Participates in anaphylactic reactions - besting, nuts, pollen
-Responsible for rejection of kidney, liver, and heart transplants
-Can also sometimes attack itself, causing "autoimmune diseases" or immune-mediated diseases
-they way the body protects itself
Perform a thorough assessment before administering immunosuppressants:
-Renal, liver, and cardiovascular function studies
-Central nervous system baseline function
-Baseline vital signs
-Baseline laboratory studies, including hemoglobin, hematocrit, white blood cell (WBC) count, and platelet count
Immunosuppressants Nursing Implications - what to monitor for
-Assess for contraindications, drug allergies, and drug interactions.
-Monitor WBC counts throughout therapy; if the count drops below normal range, contact the prescriber. - because of risk of infection
Oral forms of Immunosuppresants
-Oral immunosuppressants should be taken with food to minimize gastrointestinal upset.
-Oral forms are used when possible to decrease the risk of infection that may occur with parenteral injections.
-Note that there are several possible drug interactions.
-Grapefruit juice also interacts with some of these drugs.
Oral Antifungals of Immunosuppressants
-Oral antifungal drugs are usually given with these drugs to treat oral candidiasis that may occur. - because at risk for developing yeast in mouth
-Assess the oral cavity often for white patches on the tongue, mucous membranes, and oral pharynx.
-Mix oral cyclosporine solution in a glass container.
-Do not use Styrofoam containers because the drug adheres to the inside wall of the container.
Immunosuppressants - What to monitor for and report
-Patients taking immunosuppressants should be encouraged to take measures to reduce the risk of infection:
--Avoid people with colds or other infections.
-Inform patients to immediately report fever, sore throat, chills, joint pain, fatigue, or other signs of a severe infection.
-Monitor for therapeutic responses.
-Monitor for adverse effects and signs of drug toxicity.
Immune Response: Antigens
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
Immune Response: Antibodies
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
-Artificial active immunization: body is clinically exposed to a relatively harmless form of an antigen that does not cause an actual infection
-Natural active immunization: person acquires immunity by surviving the disease itself and producing antibodies to the disease-causing organism
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.
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
-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.
-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
-to make sure you are still able to fight against
Passive Immunizing Drugs: Antitoxins
purified antiserum that is usually obtained from horses inoculated with the toxin
Passive Immunizing Drugs: Immunoglobulins
concentrated preparation containing predominantly immunoglobulin G and is harvested from a large pool of blood donors
Snake and spider antivenins (antivenom)
-Antiserum containing antibodies against a venom, which is a poison secreted by an animal such as a reptile, insect, or other arthropod (e.g., spider).
--Most antivenins are obtained from animals (usually horses) that have been injected with the particular venom.
--Serum contains immunoglobulins that can neutralize the toxic effects of the venom.
CDC/Department of Health and Human Services recommendations for adult and pediatric immunizations (U.S.)
-Provide specific dosages and intervals for immunizations
-Refer to the CDC's website for current recommendations
-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.
Immunizing Drugs Assessment
-Assess the patient's health history, medication history, allergies, and pregnancy status.
-Assess previous reactions and responses to immunizations.
-Assess for contraindications, including immunosuppression.
Immunizing Drugs Nursing Implications
-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.
-Monitor for therapeutic responses and adverse reactions.
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