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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 / tooid
!akes "eeks to months to take effect
Passive:
Administration of preformed antibodies #immunoglobulins$
Majr !ells f t"e Immune
System
N203
ATI (Unit 3)
Immune System -
% cells &acrophages ' (endritic )ells
Produce antibodies Phagocytosis
Helper ! cells #)(*$
Activate % cells
+esponsible for delayed
hypersensitivity reaction

)ytotoic ! cells #)(,$
(irectly destroy target cells

MM# $accine
N203
ATI (Unit 3)
Immune System -
Therapeutic Uses:
&easles, &umps, +ubella
Adverse Effects:
-ocal reactions #rash, fever, s"ollen glands$
Anaphylais
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 anaphylais
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
Anaphylais
Contraindications/Precautions:
H of anaphylais
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 eposure
)hronic lymphocytic leukemia
Hep A, Hep % eposure
Adverse Effects:
-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 eposure must be kno"n #> days measles,
2 days Hep %, ?* days Hep %$
Immunstimulants
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, cardiotoicity,
neurotoicity
Hypotension
Contraindications/Precautions:
Hypersensitivity / pregnancy and lactation #)$
Interactions:
!heophylline #toicity$
Aidovudine or retrovir # neutropenia$
Antihypertensives # hypotensive effect$
Education:
+efrigerate / (o not shake vial
Immunsuppressants
(*eneral)
N203
ATI (Unit 3)
Immune System -
Act on helper ! lymphocytes to suppress proliferation of % cells and
cytotoic ! cells
<or treatment of autoimmune disorders and to prevent organ re1ection
+heumatoid arthritis
/arly type ? diabetes
-upus
&yasthenia gravis
Adverse Effects
!eratogenesis risk of infection
Medications:
)yclosporine #:engraf, Neoral$ !acrolimus
:lucocorticoids #prednisone$ &ethotreate
)ytotoics #a0athioprine$
!yclsprine
N203
ATI (Unit 3)
Immune System -
Adverse Effects:
Hepatotoicity Nephrotoicity #%BN, )reatinine, .'3$
Contraindications/Precautions:
Pregnancy / +ecent live virus vaccination / +ecent contact C chickenpo or herpes
Interactions:
Phenytoin, phenobarbital, rifampin, carbama0epine, !&P8S&A #DcyclE $
Ketocona0ole, erythromycin, amphotericin #DcyclE toicity$
Amphotericin, aminoglycosides, NSA.(s #all nephrotoic renal damage$
:rapefruit 1uice # DcyclE by FGH$
Nursing
&i oral dose C milk or 3I to palatability
Admin initial dose over @8> hours
&onitor for hypersensitivity, stay C pt9 for 4G mins
*luccrticids
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 +ecurring live virus vaccines
Interactions:
K
J
8depleting diuretics # hypokalemia$
NSA.(s # :. ulceration$
:lucocorticoids #Promote hyperglycemia$
Education:

A)at"iprine
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$
@
nd
:eneration:
-oratadine #)laritin$
)etiri0ine #Ayrtec$
<eofenadine #Allegra$
(esloratadine #)larine$
Therapeutic Uses:
&ild allergic reactions Anaphylais
&otion sickness .nsomnia
Anti"istamines
(,
st
*eneratin)
N203
ATI (Unit 3)
Immune System -
!"emt"erapy A-ents
(Medicatins)
N203
ATI (Unit 3)
Immune System -
Nitrogen mustards99999999999999999999999999999999999999999999999999999cyclophosphamide
Platinum compounds99999999999999999999999999999999999999999999999999999999999999999cisplatin
<olic acid analog9999999999999999999999999999999999999999999999999999999999999999methotreate
Pyrimidine analog9999999999999999999999999999999999999999999999999999999999999999999cytarabine
Purine analogs9999999999999999999999999999999999999999999999999999999999999999mercaptopurine
Antitumor antibiotics99999999999999999999999999999999999999999999999999999999999doorubicin
&itotic inhibitors99999999999999999999999999999999999999999999999999vincristine, paclitael
!opoisomerase inhibitors999999999999999999999999999999999999999topotecan, irinotecan
%reast cancer9999999999999999999999999999999999999999999999999999tamoifen #antiestrogen$
Prostate cancer999999999999999999999999999999999999999999999999999999999999999999999999leuprolide
Progestins99999999999999999999999999999999999999999999999999999999999999999999megestrol acetate
)ytotoic medications
Asparaginase Hydroyurea Procarba0ine
!"emt"erapy A-ents
(Side .ffects)
N203
ATI (Unit 3)
Immune System -
%one marro" suppression
Avoid cro"ds, check for bleeding gums
:. discomfort
:ive antiemetic #ondansetron$ "ith deamethasone,
metoclopramide or granisetron at outset
Alopecia 3ccur 28?G days after, persist ma of @ months after
&ucositis <reKuent oral care, soft toothbrush, /t3H mouth"ash
+eproductive toicity Sperm banking, Avoid gravid on meds9
Hyperuricemia or uric acid
fluids, .'3
:ive allopurinol if uric acid
/travasation of vesicants such as carmustine, dactinomycin,
daunorubicin, and vincristine