PPT_Chapter_40 - Immunologic Agents Chapter 40 Copyright \u00a9 2013 Wolters Kluwer Health | Lippincott Williams Wilkins Immunity Ability of the body to

PPT_Chapter_40 - Immunologic Agents Chapter 40...

This preview shows page 1 out of 30 pages.

Unformatted text preview: Immunologic Agents Chapter 40 Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Immunity Ability of the body to identify and resist microorganisms that are potentially harmful Immune system mechanisms with which it fights invading organisms include: Cell-mediated defenses (cellular immunity) Antibody-mediated defenses (humoral immunity) Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell-Mediated Immunity Result of the activity of many leukocyte actions, reactions, and interactions that range from simple to complex Depends on the actions of the T lymphocytes, which attack the antigens directly rather than produce antibodies T lymphocytes are involved in cell-mediated immunity Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins T Lymphocytes (T Cells) • Helper T4 cells — Identify and destroy antigens • Helper T1 cells — Increase B-lymphocyte antibodies • Helper T2 cells — Increase killer T cells • Suppressor T cells — Suppress the immune response • Memory T cells — Recognize previous contact with antigens and activate immune response Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Lymphocyte Production Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Humoral Immunity B lymphocytes, which produce circulating antibodies to act against a foreign substance Based on the antigen-antibody response Protects the body against bacterial and viral infections Specific antibodies are formed for a specific antigen Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Antibody Production Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Active Immunity • Naturally acquired active immunity occurs when a person is exposed to a disease, experiences the disease, and the body makes antibodies for future immunity to the disease • Artificially acquired active immunity occurs when the person is given a killed or weakened antigen, which then stimulates the formation of antibodies against the antigen – also known as vaccine Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Active Immunity • When a vaccine contains an attenuated (weakened) antigen, the individual may experience a few minor symptoms of the disease or even a mild form of the disease – Symptoms should be milder and last for a shorter time • Killed virus produces a poor antibody response compared to a better response with live, weakened virus • A “booster” injection is often needed to maintain immunity Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Available Vaccines or Immunizations Diphtheria Measles H5N1 influenza Pertussis Hepatitis A Pneumococcal disease Hepatitis B Poliomyelitis Rabies Herpes zoster Human papillomavirus Influenza (types A and B) Japanese encephalitis Meningococcal disease Mumps Rotavirus Rubella Tetanus Typhoid Varicella Yellow fever Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Passive Immunity Obtained from the administration of immune globulins or antivenins Provides ready-made antibodies from another human or an animal Provides immediate immunity but lasts for only a short time Example is hepatitis B immune globulin, which is used in an attempt to prevent hepatitis B after the individual has been exposed to the virus Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Active and Passive Immunity Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Actions of Vaccines and Toxoids Vaccinations cause antibody-producing tissue to react to an antigen, even a dead or weakened one Toxoids are capable of stimulating bacteria to produce toxins Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Vaccines and Toxoids Administered to stimulate an immune response within the body to specific antigens or toxins Must be administered before exposure to the pathogenic organism Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Vaccines and Toxoids Routine immunization of infants and children Immunization of adults against tetanus Adults at high risk for certain diseases Children or adults at risk for exposure to a particular disease Immunization of prepubertal girls or nonpregnant women of childbearing age against rubella Prevention of human papillomavirus in prepubertal girls and nonpregnant young women up to age 25 or 26 Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adverse Reactions of Vaccines and Toxoids Adverse reactions are usually mild and include chills, fever, muscular aches and pains, rash, and lethargy Pain and tenderness at the injection site may occur Hypersensitivity reactions may occur Reactions usually subside within 48 hours Risk of serious adverse reactions from an immunization is much smaller than the risk of contracting the disease for which the immunizing agent is given Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Vaccines and Toxoids Prior to administration, must provide the patient with a Vaccine Information Statement (VIS) specific for that vaccine Forms are updated regularly and are available from the CDC website Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Vaccines and Toxoids Contraindications: Acute febrile illnesses, leukemia, lymphoma, immunosuppressive illness or drug therapy, nonlocalized cancer Immunologic agents: known hypersensitivity MMR: allergic reaction to gelatin, neomycin, or a previous dose of one of the vaccines during pregnancy Women are instructed to wait at lest 3 months before getting pregnant after receiving these vaccines Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Vaccines and Toxoids Precautions: History of allergies Pregnant women Lactation Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Vaccines and Toxoids Interactions: Vaccinations with live organisms are not administered within 3 months of immune globulin administration Corticosteroids, antineoplastic drugs, and radiation therapy Salicylates with varicella vaccination Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Actions of Immune Globulins and Antivenins Globulins are proteins present in blood that contain antibodies Immune globulins are solutions obtained from human blood that contain antibodies that have been formed to specific antigens Antivenins are antitoxins specific for animal or insect venom Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Uses of Immune Globulins and Antivenins Immune globulins Provide passive immunization to one or more infectious diseases Onset of protection is rapid but short in duration (1–3 months) Antivenins Passive transient protection from the toxic effects of bites by spiders and snakes Most effective response is within 4 hours after exposure Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adverse Reactions of Immune Globulins and Antivenins Immune globulins Rare Local tenderness at the site of injection may occur Most common effects: urticaria, angioedema, erythema, malaise, nausea, diarrhea, headache, chills, fever If they occur, last for several hours Systemic reactions are extremely rare Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adverse Reactions of Immune Globulins and Antivenins • Antivenins – Hypersensitivity – most severe – Some are prepared from horse serum – if a patient is sensitive, then severe reactions may occur – Immediate reactions occur within 30 minutes – Most common: apprehension; flushing; itching; urticaria; edema of the face, tongue, and throat; cough; dyspnea; vomiting; cyanosis; collapse Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Immune Globulins and Antivenins Contraindications: Immune globulins: patients with a history of allergic reactions after administration of human immunoglobulin preparations, individuals with isolated immunoglobulin A deficiency Antivenin: hypersensitivity to horse serum or any other component of the serum Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Immune Globulins and Antivenins Precautions: Pregnancy Lactation Children Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications, Precautions, and Interactions of Immune Globulins and Antivenins Interactions: Immune globulins: live vaccines, particularly measles, but also mumps and rubella Live virus vaccines should be administered 14–30 days before or 6–12 weeks after immune globulins Antivenins: no known interactions Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Patient Management Issues with Immunologic Agents Allergy history taken before administration Patient may need to stay in clinic or office for observation for 30 minutes after injection May be beneficial to increase fluids, allow for adequate rest, and keep the atmosphere quiet and nonstimulating Acetaminophen every 4 hours or warm or cool compresses may help injection site irritation Lump may appear at injection site All adverse reactions following an immunization are collected and reported Vaccine Adverse Event Reporting System Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Educating the Patient and Family About Immunologic Agents Parents are encouraged to have their children vaccinated Those traveling to a foreign country are urged to have immunizations well in advance of their departure date Educate about vaccine and possible reactions prior to injection Educate about risks associated with immunizations All are encouraged to report any adverse reactions Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Educating the Patient and Family About Immunologic Agents If child is receiving a vaccination: Risks of contracting vaccine-preventable disease are higher than the adverse reactions associated with immunization Bring all immunization records to all visits Ask health care provider to provide you with date to return for next vaccination Adverse reactions are common and should be short-lived Acetaminophen and warm compresses should help Report any unusual or severe adverse reactions Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins ...
View Full Document

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture