1. Chapter 38 Agents That Affect Immunity

2. Immune System Functions • Recognize and dispose of foreign material such as: • -Bacteria -Worms • -Viruses -Drugs • -Fungi -Food • -Protozoa -Transplanted organs

3. Immune System • Responds to foreign agents (antigens) • Forms antibodies • Recognizes and destroys antigens • Reason for an allergic reaction

4. 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

5. 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

6. 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

7. 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

8. Types of Immunity • Passive Immunity • Administration of preformed antibodies • IgG antibodies • Provides instant protection • Short duration

9. 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

10. 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

11. 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)

12. Interferons and Interleukins (cont’d) • They are used to: • Treat cancer • Stimulate T cell production • Promote blood cell formation • Treat several inflammatory diseases

13. 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

14. Immunosuppressant Agents • Must be taken every day- no missed doses • Compliance necessary • Side effects/Adverse effects: • Nephrotoxicity, tremor, HTN, gum hyperplasia, nausea…

15. 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