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CHAPTER 46 Immunizing Drugs and Biochemical Terrorism

CHAPTER 46 Immunizing Drugs and Biochemical Terrorism. Immunity. Immune response Antigens Antibodies Active immunization Passive immunization. Immunizing Biologicals. Biological antimicrobial agents Also called biologicals Used to prevent, treat, or cure infectious diseases Antitoxins

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CHAPTER 46 Immunizing Drugs and Biochemical Terrorism

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  1. CHAPTER 46Immunizing Drugs and Biochemical Terrorism Winter 2013

  2. Immunity Immune response Antigens Antibodies Active immunization Passive immunization Winter 2013

  3. Immunizing Biologicals Biological antimicrobial agents Also called biologicals Used to prevent, treat, or cure infectious diseases Antitoxins Antisera Toxoids and vaccines (immunizing biologicals) Winter 2013

  4. Toxoids Antigenic (foreign) preparations of bacterial exotoxins Detoxified with chemicals or heat Weakened or “attenuated” Cannot revert back to a toxic form Winter 2013

  5. Toxoids (cont’d) Stimulate one’s immune system to produce a specific antibody Artificial active immune response These antibodies protect against future exposures Winter 2013

  6. Vaccines Suspensions of live, attenuated (weakened) or killed (inactivated) microorganisms The weakened form prevents the person from contracting the disease Winter 2013

  7. Vaccines (cont’d) Also stimulate the production of antigens against a specific antibody Vaccinations with live bacteria or virus provide lifelong immunity Vaccinations with killed bacteria or virus provide partial immunity, and booster shots are needed periodically Winter 2013

  8. Active Immunization The body is exposed to a relatively harmless form of an antigen The immune system is stimulated and “remembers” this antigen if subsequent exposures occur Do not cause a full-blown infection Winter 2013

  9. Active Immunizing Drugs: Examples BCG vaccine (tuberculosis) Diphtheria, tetanus, and pertussis toxoids, several forms Haemophilus influenzae type B conjugate vaccine Hepatitis A and B virus vaccines Winter 2013

  10. Active Immunizing Drugs: Examples (cont’d) Measles, mumps, and rubella virus vaccine, live—several forms Pneumococcal bacterial vaccines Human papilloma virus vaccine (Gardasil) Poliovirus vaccine; several forms Rabies virus vaccine Winter 2013

  11. Active Immunizing Drugs: Examples (cont’d) Smallpox virus vaccine Tetanus toxoid Varicella virus vaccine (chickenpox) Yellow fever virus vaccine Many others Winter 2013

  12. Passive Immunization Serum or concentrated immune globulins from humans or animals are injected into a person The substances needed to fight off invading microorganisms are given directly to a person The immune system is bypassed Short-lived compared with active immunization, but works faster Winter 2013

  13. Passive Immunization (cont’d) Naturally acquired passive immunity From mother to fetus through the placenta From mother to infant through breast milk Artificially acquired passive immunity Acquired from an external source, such as injection of antibodies or immunoglobulins Winter 2013

  14. Passive Immunizing Drugs Antitoxins Immunoglobulins Snake and spider antivenins (antivenom) Winter 2013

  15. Passive Immunizing Drugs: Examples Antivenins Pit viper, coral snake Black widow spider Hepatitis B immune globulin Immunoglobulin, various forms Rabies immunoglobulin (human) Winter 2013

  16. Passive Immunizing Drugs: Examples (cont’d) Rho(D) immune globulin (RhoGAM) Tetanus immunoglobulin Winter 2013

  17. Indications Active immunization Prevents infection caused by bacterial toxins or viruses Provides long-lasting or permanent immunity “Herd immunity” Winter 2013

  18. Indications (cont’d) Passive immunization Antitoxins, antivenins, immunoglobulins Minimizes effects of poisoning by the venoms of spiders and certain snakes Provides quick immunity before a person’s own immune system has a chance to make antibodies (such as in cases of exposure to hepatitis B or rabies viruses) Winter 2013

  19. Indications (cont’d) CDC/Department of Health and Human Services recommendations for adult and pediatric immunizations (U.S.) Provide specific dosages and intervals for immunizations Refer to the CDC website for current recommendations Winter 2013

  20. Adverse Effects Range from mild and transient to very serious or life threatening Minor effects Fever, minor rash, soreness at injection site, itching, adenopathy Severe effects Fever higher than 103° F, encephalitis, convulsions, anaphylactic reaction, dyspnea, others Winter 2013

  21. Adverse Effects (cont’d) Minor reactions Treated with acetaminophen and rest Serious or unusual reactions Serum sickness Report serious or unusual reactions to the Vaccine Adverse Event Reporting System (VAERS) Winter 2013

  22. Nursing Implications Assess previous reactions and responses to immunizations Assess for contraindications, including immunosuppression Winter 2013

  23. Nursing Implications (cont’d) Before giving any drug, recheck the specific protocols for administration and schedules for administration Winter 2013

  24. Nursing Implications (cont’d) Encourage parents of young children to keep a journal of the child’s immunization status, with dates of immunizations and reactions, if any Winter 2013

  25. Illnesses Caused by Possible Bioterrorism Agents Anthrax Smallpox Botulism Tularemia Viral hemorrhagic fever Plague Winter 2013

  26. Possible Bioterrorism Agents Sarin (nerve gas) Mustard (blistering agent) Cyanide (blood agent) Chlorine (choking agent) Radioactive elements Ricin Winter 2013

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