Nurs 3366 - Abnormalities in Inflammation and Third line of Defense

What abnormalities occur when there is “not enough” inflammation?

quantitative defect (example-- from chemotherapy)

• leukopenia --deficiency in WBC

• deficiency in neutrophils-- neutropenia

qualitative defects

• chemotactic defects—won’t respond appropriately when “summoned.”

• impaired function; ex—phagocytes have decreased ability to fight microbes

What abnormalities occur when there is “too much” inflammation?

• SIRS

• sepsis

• chronic inflammation

What is SIRS?

systemic inflammatory response syndrome

• occurs when a normal systemic inflammatory response goes into
  overdrive – the normal “braking” system of the inflammatory process does not occur

Why is SIRS harmful?

a systemic response → instead of healing, systemic inflammation goes into overdrive → SIRS → widespread tissue/organ damage

What is Sepsis?

occurs when there is a known or suspected infection AND the person has SIRS

What is Septic shock?

occurs when sepsis (infection + SIRS) is complicated by low blood pressure.

• often fatal

What are the Therapeutics for Inflammation?

non-medicinal interventions

• ice on area of swelling - numbs pain and causes vasoconstriction diminishing swelling

medicinal therapeutics

• antiinflammatory medications - suppress the effects of prostaglandins

  • Steroids and NSAIDs

What are the 2 types of Prostaglandins?

Proinflammatory and Protective PGs

• created by the Arachnoid pathway

What is the function of Protective PGs?

• maintain normal platelet clotting function (P)

• maintain the integrity of the gastric mucosa (G)

• promote healthy renal function. (R)

• maintain appropriate vasomotor tone. (V)

• maintain normal immunocyte function. (I)

ProstoGlandins R Very Important

How do Steroids help stop Inflammation?

suppresses the prod. of both proinflammatory and protective PGs

• by inhibiting phospholipase which stops the creation of arachidonic acids - cant make prostaglandins or leukotrienes

What is a patient at risk for while taking Steroids?

stomach ulcers, easier bleeding, diminished kidney function, immunocompromised, increased skin fragility, hypertension(HTN)

What are NSIADs

non-steroidal anti-inflammatories

How do NSAIDs help stop Inflammation?

work lower in the arachidonic pathway suppresses the prod. of COS enzyme

• stops prod. of PGs but leukotrienes are prod.

What are examples of NSIADs?

aspirin, ibuprofen (Motrin), naproxen

What is the Third line of Defense?

normal immunocyte response (AKA acquired immunity)

• delayed and specific

What are the 2 types of immunocytes?

T lymphocytes - cell-mediated

B lymphocytes - humoral

What are the sub-catagories of T-lymphocytes?

• CD4 cells (AKA helper-T) - act as “introductory” cells.

• CD8 cells (AKA cytotoxic T-cells) - act as direct killers

• Memory T cells - memorize microbe properties

What are the sub-catagories of B-lymphocytes?

• Plasma cells - create antibodies to the microbe that has attacked the body

• Memory B cell

What is active immunity?

person’s own immunocyte system develops the antibodies that establish immunity

What is Natural Active acquired immunity

person’s plasma cells build up antibodies in response to a microbially-induced illness

What is Artificial Active acquired immunity?

person’s plasma cells build up antibodies in response to receiving vaccinations

What is Passive immunity?

given someone else’s antibodies; they did not develop the antibodies on their own.

What is Natural Passive acquired immunity

this occurs when there is a transfer of antibodies from mom to baby via placenta or breast milk

• MatAb

What is a Artificial Passive acquired immunity?

when antibodies are injected during treatment, usually in emergencies or as a stop-gap measure until active immunity can develop

How does Humoral immunity defeat microbes?

neutralization (inactivation): of the toxin invading the body

opsonization: “coats” bacteria—this promotes phagocytosis by optimizing recognition