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Immunology

Immunology. Anatomy, Allergic and Anaphylaxis, Anaphylactoid reactions, Collagen Vascular disease, and transplanted related problems. Immune System. Terms Immune system -the body system responsible for combating infection

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Immunology

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  1. Immunology Anatomy, Allergic and Anaphylaxis, Anaphylactoidreactions, Collagen Vascular disease, and transplanted related problems

  2. Immune System • Terms • Immune system-the body system responsible for combating infection • Immune response-complex cascade of events that works towards the destruction of pathogens or abnormal cells. • Antigens-a marker on the surface of cell that identifies it as “self” or “non-self” • Antibody-a substance produced by B lymphocytes in response to the presence of a foreign antigen that will combine with and control the antigen, thus preventing infection • Immunity-a long term condition of protection from infection or disease

  3. Immunity types • Natural VS. Acquired • -Natural=not part of the immune response, inborn part of your genetic make-up • -Acquired=develops as an outcome of the immune response • Passive-transferred to a person from outside source. • Active-generated by the immune response after exposure to a antigen

  4. Immunity types • Humoral VS. Cell-Mediated • Lymphocytes • WBC • Recognizing foreign antigens • Producing Antibodies • Developing Memory • B&T Lymphocytes • B-Do not attack Antigens directly produce antibodies-confer long term immunity=Humoral • T-Attack antigens directly=Cell-Mediated

  5. Humoral Immunity • Basically a chemical attack of an invading substance • Basic fighter=Antibodies AKA=IMMUNOGLOBINS • Speclized Cells (B-Cells) 5 types • IgA • IgD • IgE-most important for allergic reactions • IgG • IgM

  6. Humoral Response • Primary-Never exposed to antigen before. • Antigen enters body • Body respond by producing Antibodies • Specifically IgE • Antibodies remain • The patient is primed for another exposure to that antigen • THIS IS SENSITZATION • Secondary- the body remembers Antigen and attacks it quickly

  7. Allergy • Initial exposure of antigen is referred to as sensitization • Subsequent exposure induce a faster and stronger response • Some individuals become HYPERSENSITIVE to particular antigens • Unexpected and exaggerated reaction to a particular antigen. Used synonymously with allergy.

  8. Hypersensitive • Two types • Delayed • No cellular immunity • Hours and days following-skin rash • Example-Poison Ivy • Immediate • Large quantaties of IgE • Antigen that does this is referred to as Allergen • Allergen can enter the body through various routes • Large majority of Anaphylactic reaction result from injection or envenomation

  9. Anaphylaxis • An exaggerated allergic reaction to a foreign protein or other substance • Common substances • PCN • Insect stings • Radio-contrast dye • Food-peanuts/shellfish • Systems effected • Cardiac • Respiratory • GI • Skin

  10. Anaphylaxis

  11. Anaphylaxis

  12. Histamine Effects • Increased Capillary Permeability • Vasodilation • Bronchoconstriction • Increased Mucus secreation • Two classes • H1-cause bronchoconstriction and GI contraction. • H2-cause peripheral vasodilation and increased capillary permeability • SRS-bronchoconstiction/potentiates Histamine

  13. Anaphylaxis

  14. Anaphylactic S/SX • Generalized • Itchy, watery, red eyes • Runny nose • CNS • Anxiety/restlessness • Confusion • HA • SZR • Skin • Itching and tingling • Uticara(hives) • Flushed or red skin • Swelling of the hands or face

  15. S/SX • Respiratory • Chest and throat tightness • Increase RR/Labored breathing • Stridor, Hoarness • Cardio • Tachycardia • Hypotension • Weak pulses • GI • N/V • Diarrhea • Cramping

  16. Hives

  17. Angioneurotic edema

  18. Treatments • Mild/Moderate/Severe • Airway(monitor for horseness, edema, stridor) • 02,,EKG BVM prn • IV fluids maintain >90 BP • EPI 0.3mg SQ/0.1-0.3mg SIVP • Benadrly 50mg • Solu-medrol125mg • Albuterol/Atrovent 2.5-5mg/.5mg

  19. EPINEPHRINE • Names- • Actions-Adrenergic stimulant A&B receptors. Increased HR, Cardiac contractile force, vasoconstriction • Indications-Anaphylaxis/Hives • Dosage • 1:1000/0.3mg/SQ adult .01mg/kg pediatric SQ • 1:10000/0.1-0.3mg/SIVP • Contraindications/Precautions-Patients with underlying heart disease. Those in profound anphylaxis may be peripheral vasoconstricted so SubQepi may not work

  20. Diphenhydramine • Names-Benadryl • Actions-antihistamine blocks both H1 and H2 receptors • Indications-Anaphylaxis/allergic/dsytonic reactions • Dosage-25-50 mg SIVP or IM • Contraindications-not used in asthma. In severe cases be sure to use EPI first. Can cause hypotension, HA, palpitations

  21. SOLUMEDROL • Names-Methylprednisone • Actions-steriod with anti-inflammatory properties • Indications-Severe Anaphylaxis • Dosage and routes-125 to 250mg IV or IM • Contraindications/Precautions-None for anaphylaxis. One dose for patients.

  22. Albuterol • Names-Proventil, ventolin • Action-Cause bronchodilation strong b2 properties with minimal side effects • Indications-Asthma, Anaphylaxis • Dosage/routes-2.5-5mg Neb • Contraindication/Precautions-Can cause palpitations, anxiety, dizziness, HA, nervousness.

  23. Atrovent • Names-Ipratropium • Action-Anticholinergic, bronchodilator. Dries respiratory secreations • Indications-Asthma, Anaphylaxis • Dosage/routes-.5mg NEB • Contraindication/Precautions-few interactions with other meds. Breathing treatment should behind EPI and Benadryl with Anaphylaxis

  24. IM and SQ injections

  25. Anaphylactoid Reactions • No previous Antigen exposure • Not the typical Antigen-Antibody exposure • The substance that the patient is taking in, is causing the breakdown of basophilis and mast cells • First time exposure may present as a Anaphylactic reaction

  26. Anaphylactoid • Common susbstances • NSAIDS • ASA • Opiates • Thiamine

  27. Collagen Vascular Disease • Collagen vascular disease occurs when problems with the immune system affect collagen • Collagen is a tough strong protein that comprises most of the body’s connective tissue • Fibroblast-specialized cells that form collagen • In a class of diseases known as autoimmune disorders, the body's immune system attacks its own tissues

  28. Examples of CVD • Systemic lupus erythematosus(SLE) – inflammation of the connective tissues, can afflict every organ system. It is more common in women than men. • Rheumatoid arthritis – a systemic disorder in which immune cells attack and inflame the membrane around joints. It also can affect the heart, lungs, and eyes. • Scleroderma– activation of immune cells that produces scar tissue in the skin, internal organs, and small blood vessels. • Sjögren'ssyndrome – aka Sjögren's disease, is a chronic, slowly progressing inability to secrete saliva and tears. It can occur alone or with rheumatoid arthritis, scleroderma, or systemic lupus erythematosus.

  29. Transplant related Problems • Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed closely by the liver and then the heart. The cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold.

  30. Problems • Transplant rejection occurs when transplanted tissue is rejected by the recipient's immune system, which destroys the transplanted tissue. • Less by matching donors and immunospressive drugs • Rejection categories include Hyperacute, Acute and Chronic

  31. THE END

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