pharm immune system part 1

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pharm immune system part 1
2014-04-10 23:04:03
immune part 1
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  1. immune response and antibodies
    • antigen enters B cell
    • B cell becomes active and replicates (replicated cells produce specific antigens)
    • Afterward Memory B cells are formed
    • can be short or long acting
  2. what is the goal of vaccine?
    induce long acting immunity without producing illness

    contraindicated for people with weak immune systems
  3. live vaccine  vs inactivateddead vaccine
    live contains microbes that are alive but are weakened so they produce an immune response but no illness

    inactivated contain microbes that have been inactivated by heat or chemicals and are unable to cause disease

    body has the same response
  4. active immunity
    response produced by the real pathogen or its vaccine
  5. passive immunity
    performed when antibodies are transferred or donated  from 1 person to another

    breastfeeding, mother to fetus
  6. immunostimulants
    used to treat many different conditions such as Kaposi's Sarcoma, MS, Lymphoma, skin cancer
  7. immunostimulants: interferons

    mech of action
    • Interferons warn surrounds cells that a virus has occurred
    • attach to uninfected cells to produce antiviral proteins
  8. Immunostimulants: Interleukins

    Mech Of Action
    Stimulate and enhance the capabilities of the immune system

  9. Immunostimulants

    Adverse effects
    Given IM or SubQ

    • Flu-like symptoms
    • Depression and suicidal ideation (interferons)
    • Can aggravate autoimmune disorders

    • Autoimmune disorders (will cause immune system to attack itself)
    • Benzyl Alcohol
  10. overdose of immunostimulants
    Lethargy and coma

    no antidote
  11. Immunosuppressants
    • commonly given for prevention of transplant rejection and autoimmune disorders
    •  weakens the immune system and alters T cell function
  12. immunosupressants

    Mach of action
    Alters T Cell function
  13. Immunosupressants

    Adverse effects
    PO, IV, SQ

    • Infection!!
    • Bone Marrow suppression
    • Malignancies
    • Gingval Hyperplasia and stomatitis

    Contr: active infections
  14. Nursing Process Immune
    • VS
    • weight and height
    • oral and dental health assessment
    • labs

    • implement: Monitor BP and temp
    • observe S/S infection
    • infection prevention
    • dental health
  15. inflammation
     why do we need it
    try to keep infection from spreading through the body
  16. treating inflammation
    • inflammation is a symptom not a disease
    • it is the body's natural process of riding the body of antigens
    • goal is to decrease the intensity of the inflammation response and reduce fever
  17. NSAIDS
    • treat mild to moderate inflammation
    • analgesic and antipyretic actions
  18. NSAIDS
    Mech of action
    inhibit COX which is the key enzyme in the synthesis of prostaglandins

    most traditional NSAIDS block COX-1 and COX-2
  19. COX-1 vs COX-2
    COX-1: present in all tissue and has protective functions

    COX-2: Formed after tissue injury and promotes inflammation
  20. if taking anticoagulant you should not take NSAID, it can cause bleeding
  21. NSAIDS

    Mostly PO, some IV

    • AE: GI Upset! (can lead to GI ulcers)
    • Renal Failure
    • Some risk for bleeding

    • Contr: Active peptic ulcers
    • Renal Impairment
    • Serious HTN or Stroke
  22. Drug interactions with NSAIDS
    • antiplatelet and anticoagulants
    • Diuretics (decrease effects)
    • ACE Inhibitors (decrease effects)
  23. Salicylates  (Aspirin)
    • Binds to COX-1 and COX-2 to prevent them from forming prostaglandins
    • Decreases platelet aggrigation
    • Can be enteric coated to ease GI upset
    • Salicylates toxicity can cause metabolic acidosis or tinnitus
  24. COX-2 Inhibitors
    Do Not Inhibit COX-1

    • Most withdrawn from the market in 2004
    • More likey to have heart attacks
  25. Corticosteriods

    Mech of Action
    • Inhibit the synthesis of prostaglandin
    • Suppress histamine release
    • Inhibit certain immune functions
  26. Corticosteroids

    Adverse Effects
    PO, IV, IM, inhalation

    • AV: mood swings
    • weight gain
    • Acne
    • Osteoporosis
    • making infection
    • Moon Face
    • Cushing Syndrome
    • Hyperglycemia
  27. Corticosteroids cannot be stopped suddenly they must be TAPPERED
  28. interactions
    • amphotericin B, Diuretics
    • Hypoglycemics

    Contr: active infection
  29. Fever
    • natural body function to kill off unwanted organisms
    • usually mor of a discomfort when from an illness
    • Febrile seizures
    • Drug Induced fever
  30. Tylenol

    Mech of Action
    • Acts on hypothalamus to reduce fever
    • Dilates peripheral blood vessels
    • no anti-inflammatory actions
    • Can be used in comb with opioids to reduce opioid dose
  31. tylenol

    Adverse Effects
    Usually Po, can suppository

    • AE: few adverse effects in therapeutic doses
    • Usually GI in Nature
  32. drug interactions and contraindications with Tylenol
    • DI: inhibits Coumadin metabolism
    • Hepatotoxic drugs

    Contra: Liver Injury
  33. Tylenol overdose
    • metabolite NAPQI responsible for toxicity
    • Cannot assess toxicity prior to 4 hours post ingestion
    • initially no symptoms
    • Vomiting, RUQ pain
    • Check ALT/AST, PT/INR
    • metabolizes in the liver
  34. how to treat Acetaminophen/Tylenol overdose

    • PO, dilute in juice or soda
    • 140mg/kg loading dose
    • 70mg/kg maintenance dose
    • if patient vomits dose within 1 hour of admin repeat dose
    • absorption is slow
  35. how to treat Acetaminophen/Tylenol overdose

    • IV
    • 150mg/kg - loading dose over 1 hour 
    • 50mg/kg - over 4 hours
    • 100mg/kg - over 16 hours

    10 fold doses have been fatal
  36. Nursing Process for inflammation/fever
    vitals, med history

    • interventions: RICE
    • monitor fever at home
    • s/s bleeding
    • s/s/toxicity
    • urine output
    • liquid medication doses
    • weight