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Levels of body defense
- Barrier Defenses
- Cellular Defenses
- Inflammatory Response
- Immune Response
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Name your bodies barrier defenses:
- Skin
- Mucous Membranes
- Gastric Acid
- Major Histocompatibility Complex (MHC)
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Which barrier defense protects internal tissues and organs of the body?
Skin
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Describe where Mucous membranes would be found:
- Respiratory Tract
- Gastrointestinal Tract (GI)
- Genitourinary Tract (GU)
Lines areas of the body that may be exposed to external influences, but not have skin on them.
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Describe the MHC:
Major Histocompatibility complex is the last barrier defense.
Distinguishes between self-cells and foreign or non-self cells.
Produces proteins (histocompatibility antigens) or Human Leukocyte Antigens (HLA's)
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Name a type of Cellular Defense:
Mononuclear Phagocyte System (MPS)
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Thymus gland, lymphatic tissue , leukocytes, lymphocytes, and chemical mediators are all part of what defense system?
Cellular defenses = MPS
mononuclear phagocyte system
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What are leukocytes?
White blood cells
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What are lymphocytes?
white blood cells, with varied nuclei
T or B Cells
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Where are Myelocytic cells made?
Bone Marrow
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Name 4 mylocytic cell types:
- Neutrophils
- Eosinophils
- Basophils
- Monocytes / macrophages
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Describe neutrophils:
engulf/digest foreign material by phagocytosis.
Most common white blood cell
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What do Eosinophils do?
often found at the site of an allergic reation
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Describe basophils:
release chemical mediators (histamine / heprin)
Mast Cells
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Describe Monocytes/ macrophages:
- Eat up dead tissue or cell debris
- Process antigens marked for destruction
- May circulate or be fixed
- Ellicite a strong inflammatory response
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Lymphoid tissues include:
- Lymph nodes
- Spleen
- Thymus gland
- Bone Marrow
- Lymphoid tissue in the Respiratory & GI tract
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Hagaman factor is what type of response?
Inflammatory
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What does Hagaman Factor do?
Activates Kinin system / clotting cascade / plasminogen system (dissolves clots)
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Brakykinin is triggered by what?
Hagaman Factor
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What does Brakykinin cause or trigger next?
Release of Arachidone Acid from the cell membrane
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What responses do Arachidonic Acid cause?
- The release of Autacoids :
- Prostaglandins
- Leukotrienes
- Thromboxanes
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What do prostaglandins do?
Cause more inflammation
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What are Leukotrienes responsible for?
Vasodilation, increase capillary permeability
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What do Thromboxanes do?
Vasoconstriction, platelet aggregation, and blood coagulation
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Composed of leukocytes, lymphocytes, lymphoid tissues and chemical mediators, the _______ system is refer to as the human inflammatory and immune system
Mononuclear Phagocyte System
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A foreign pathogen that gets past the barrier defenses will encounter what system?
Mononuclear phagocyte system
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Produced in the bone marrow - includes neutrophils, basophils, eosinophils, and monocytes :
Myelocyte
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____ utilizes phagocytosis to destroy foreign material;' refereed to phagocytes.
Neutrophils
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___ responds when and injury to cell membrane causes release of histamine, leads to vasodilation and altered capillary permeability. Stimulates pain perception.
Histamine
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____ is responsible for activating the Kinen, clotting, and plasminogen systems.
Hageman Factor
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____ causes local vasodialtion, pain stimulus, and the release of arachidonic acid.
Bradykin
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Prostaglandin's, Leukotrienes, and Thromboxanes are activated by the release of what?
- Autacoids
- (act like local hormones)
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These are mast cells that do not circulate and are found in the respiratory, GI and skin:
Basophils
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These provide cell mediated immunity and include 3 different types (effector cells, helper, and suppressor):
T cells
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These cells are programmed to ID protiens or antigens AND provide humoral immunity:
B Cells
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These take several days to occur along with memory cells to use in future encounters with an antigen
Antibody formation
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Interferons and Interleukins are considered _______ mediators of the immune response .
Other mediators
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_____ has antipyretic and analgesic properties as well as decreases platelet aggregation - this all occurs by inhibiting the synthesis of prostaglandins.
Salicylates
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___________ blocks the release of histamine in the initiation of the inflammatory response.
antihistamines
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____ is a DMARDs used to treat arthritis (blocks interleukin-1).
Anakinra
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what is the prototype for Saliclates?
Aspirin
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___ provides strong anti-inflammatory and analgesic effects over the counter - examples include ibuprofen/ naproxen.
NSAIDs
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NSAIDs stands for what?
non-steroidal anti-inflammatory drugs
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___ is the alternative to salicylate/NSAID prototype:
Tylenol
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what is the most used drug for managing pain and fever in children?
Tylenol
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blocks the inflammatory response and immune system by altering the chemical reaction:
corticosteroids
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What would a contraindication be for salicylates?
abnormal bleeding or impaired renal function
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acts directly on the thermoregulatory cells in the hypothalamus:
acetaminophen
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Name a cox two inhibitor:
Celebrex
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Corticosteroids, antihistamines, salicylates and NSAIDs are all what ?
anti-inflammatory agents
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antidote to acetaminophen is?
acetylcysteine
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Ibuprofen is the prototype drug for what?
NSAIDs
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Adverse effects of salicylates:
GI irritation, Clotting system, eighth cranial nerve stimulation, and salicylism (tinnitus, acidosis)
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Indications for ASAIDs:
Relieves of arthritis pain, dysmenorrhea (menstruation pains), fever
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Give the pharmacokinetics of salicylates:
absorbed in stomach, peaks in 5-30 minutes, metabolized in liver, excreted in urine
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Pharmacokinetics of Acetaminophen:
absorbed in GI tract, peaks in 1/2 to 2 hours, metabolized in liver, excreted in urine - half life 2 hours.
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contraindications of salicylates:
bleeding abnormally or impaired renal function
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Contraindications of ASAIDs:
- cardiovascular disfunction
- hypertension
- Peptic ulcer
- GI bleeding
- pregnancy/lactation
- Caution with renal/hepatic dysfunction
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Oldest sedative-hypnotic.
Causes sedation, hypnosis, anesthesia, coma.
Less effective, High risk of addiction
CNS, cerebral cortex depressant.
Barbituates
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Barbituate prototype:
Phenobarbital
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Treatment of insomnia:
Ambien
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Ambien is a _____ drug.
anxiolytic / hypnotic
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Benzodiazepine prototype:
Diazepam
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______ calm and provide an unawareness of he environment.
sedatives
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anixiolytics cause what?
prevent feelings of tension or fear
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Benzodiazaqpine indications:
Anxiety disorders, sedation, alcohol withdrawal, agitation, pre-op anxiety.
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Most frequently used anxiolytic drugs:
bezodiazepines - prevent anxiety without causing much associated sedation.
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Drug interactions for benzodiazephine:
Increase when used with alcohol, tagament, oral contraceptives, antabuse.
Decrease with theophylline, zantac
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Most frequently prescribed sedative-hypnotic -
controlled substance IV; acts on limbic to make GABA more effective:
Benzodiazepines
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Anxiety, sedation, insomnia, pre-anesthesia, and seizures are all indications for what?
Barbituates
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Somnolence, confusion, coma, rare hypotension and respiratory depression are a sign of ______ and can be treated with______.
- Benzodiazepine overdose
- treat with Romozicon
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Adverse effects of barbituates?
CNS depression, drowsiness, lethargy, vertigo, Reduced REM sleep (agitation, inability to deal with stress)
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Contraindications of barbituates?
- Addiction history
- Porphyria (accumulation of body chemicals)
- Hepatic impairment
- Pregnancy
- Respiratory dysfuntion
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Produces a state of tranquillity:
mild tranquilizers
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Barbituate pharmacokinetics:
Well absorbed, peaks in 20-60 minutes, metabolized in liver, excreted in urine
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Benzodiazepine pharmacokinetics:
- Absorbed in GI
- peaks in 30 minutes - 2 hours
- crosses placenta/ breast milk
- lipid soluble
- metabolized in liver
- excreted in urine
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Preoperative medication __________.
Postoperative medication to decrease narcotic need _____________.
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Sedation, depression,, blurred vision, constipation, N/V, hypotension, urinary retention:
Benzodiazepine adverse effects
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This part of the brain controls crude movements, such as unconsciously controlled muscle activity like BALANCE:
Extrapyramidal Tract Control
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What does Baclofen do?
used to alleviate s/s of spasticity - may be used with Spinal cord injuries or diseases
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Name a central acting skeletal muscle relaxant:
Baclofen
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