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Chapter 38. Agents That Affect Immunity. Immune System Functions. Recognize and dispose of foreign material such as: -Bacteria -Worms -Viruses -Drugs -Fungi -Food -Protozoa -Transplanted organs.
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Chapter 38 Agents That Affect Immunity
Immune System Functions • Recognize and dispose of foreign material such as: • -Bacteria -Worms • -Viruses -Drugs • -Fungi -Food • -Protozoa -Transplanted organs
Immune System • Responds to foreign agents (antigens) • Forms antibodies • Recognizes and destroys antigens • Reason for an allergic reaction
The Immune System • Mast cells • Large tissue cells • promotes inflammation • increases permeability of blood vessels • PMN’s • ’scavenger’ white blood cells • contains powerful antibacterial enzymes • Macrophages • -large tissue cells • -removes damaged cells, bacteria, and other debris
Immune Responses • Exposure to environmental antigens • Immune system may overreact • Results in an allergic response • Can be decreased by desensitization • Body may reject own tissue • Autoimmune response • Rheumatoid arthritis or systemic lupus erythematosus (SLE) • Organ graft
Immune Responses • Normal response requires a series of interactions • Defects cause decreased effectiveness of immune system • Increases susceptibility to infection • Causes could include: • -genetic defects • -aging • -immunosuppressant drug use • -HIV/AIDS
Types of Immunity • Active immunity • Administration of an antigen, a weakened or killed vaccine • Stimulates your immune system to form antibodies against the disease • Lasts for many years
Types of Immunity • Passive Immunity • Administration of preformed antibodies • IgG antibodies • Provides instant protection • Short duration
Nursing Considerations • Obtain a full history, including allergies, pregnancy, immune status, medical condition, and past response to immunizations, prior to giving the vaccines • Follow directions for administration and storage of the vaccines • Have emergency equipment available • Deltoid muscle or vastus lateralis muscle for IM injection sites
Nursing Considerations • Ibuprofen or Tylenol for premedication • Observe the patient after the vaccine administration for any distress • Keep accurate records • Educate patients on side effects of vaccines and symptoms to report
Interferons and Interleukins • Synthetic IM injection • Stimulate the immune and inflammatory response • Assist with communication between the cells of the immune (and other) system(s)
Interferons and Interleukins (cont’d) • They are used to: • Treat cancer • Stimulate T cell production • Promote blood cell formation • Treat several inflammatory diseases
Immunosuppressant Agents • Examples: Azathioprine/Imuran, Cyclosporine/Sandimmune, CellCept • Prevent organ rejection after transplant • Used in combination with corticosteroid therapy • Combined with corticosteroids • Total mechanism of action is unclear • They suppress T lymphocytes
Immunosuppressant Agents • Must be taken every day- no missed doses • Compliance necessary • Side effects/Adverse effects: • Nephrotoxicity, tremor, HTN, gum hyperplasia, nausea…
Immunosuppressant Agents • Many Drug-Drug interactions • Medication changes should be cleared through the transplant physician Clients need to avoid infections -Instruct to wear a mask if going out Immunosuppressant agents are expensive -Cost $50,000/year or more