Pharmacology: Hematopoiesis and Immune System

Cytokines

___ are mediator cells released by the immune cells. Act as chemical messengers or stimulate the proliferation of blood cells

1. colony stimulating factors

2. interferons

3. interleukins

what are 3 examples of cytokines

colony stimulating factors

___ stimulate the production of RBC, WBC and platelets

Interferons

___ "Interfere" with viral replication; block the proliferation of tumor cells

interleukins

___ have a wide range of actions such as: stimulating the proliferation of various immune cells, activating and/or attracting immune cells, enhancing the action of immune cells, promoting inflammation and killing tumor cells

18

___ cells are identified as interleukins

Natural (innate) immunity

___ is what we are born with....physical barriers (i.e. integument), WBC's, mucus membranes

Acquired Immunity [occur after exposure to a foreign substance]

___ is immunity that occurs when the body is exposed to an antigen and antibodies against the antigen are produced by the body within 7-10 days. The cells of the body "remember" the offending antigen [memory cells]; this type of immunity may last for a lifetime. A "booster" injection of the antigen allows antibody levels to increase and continue to active immunity for a particular antigen.

active immunity

acquired immunity is also know as ___

passive immunity

___ is immunity that originates from the immune system of one person and transferred to another person (i.e. placental/breast feeding). This is short-term, lasting only weeks to months.

cellular immunity

___ is an immune response that relies on T cells to destroy infected body cells

humoral immunity

___ specific immunity produced by B cells that produce antibodies that circulate in body fluids

antigens

___ are foreign substances that the body recognizes as "non-self" - initiates the immune response

immune cells

___ maintain the body's defense against foreign and infectious material

lymphocytes and macrophages

___ are immune cell type that are able to migrate freely amount blood and lymphoid organs

maternal

Most fetal protection is provided by ___ antibodies

IgG

___ levels are very high (adult level) at birth, but decline due to the source is depleted and is gone by about 6 months

age

Immune system declines with ___ placing this population at increased risk of infections and neoplasms. (older adults)

older adults

___ may have increased antibodies against their own tissues (autoimmune) and may manifest vague symptoms with infections (i.e. no fever, confusion)

nutrition

Satisfactory ___ enables the immune system to function more effectively.

zinc, folic acid

Supplements such as ___ can aid the immune system

Stress

___ increases the risk of developing infections

antibody

Immunizations / vaccinations involve administering an antigen with the goal of stimulating ___ production. All immunizations are regulated by the FDA.

weakened (attenuated) or killed.

Vaccine preparation that contains microorganisms are either ___ or ___

attenuated (weakened)

Vaccines may produce long-term immunity - possibly a lifetime. Vaccines that are ___ are risky for immunocompromised individuals.

H. influenzae, hepatitis B

what are 2 examples of "dead" vaccines

MMR, varicella

what are 2 examples of attenuated vaccines

toxoid

___ is a toxin that is bacterial in origin and has been changed to a nontoxic form

antitoxins (antibodies against the toxins)

Toxoids stimulate the immune system to produce ____

tetanus toxoid, diphtheria toxoid

what are 2 toxoids that need repeated boosters

serums

___ are substances used to provide temporary passive immunity to an individual exposed to a disease

Immune globulin

___ is a serum made from individuals with high levels of IgG

HIV, Hepatitis , CMV, varicella zoster, rabies, RSV

plasma is a serum checked for what 6 things

-US

-Western hemisphere

Rubella is virtually eliminated in the ___; polio gone from ___; smallpox eradicated

2

Each year in the US approximately __ million children do not receive vaccinations

"vaccine-preventable diseases" (VPD)

All health care providers should report ___ to local health departments who in turn report to the CDC

National Childhood Vaccine Act

___ of 1986 requires a permanent record of childhood vaccinations

o Date of vaccination

o Route / site of vaccination

o Vaccine type / manufacturer / lot number / expiration date

o Name / address / title of person administering vaccine

Data required for the patients vaccine permanent medical record include what 4 things

Q 10 years

Diphtheria/Tetanus should be administers every ___

rubella

Prepubertal females/women of child-bearing age should be vaccinated against ___. There is an increased risk of birth defects in the newborn if the mother becomes infected with the rubella virus in the first trimester of pregnancy.

forms of erythropoietin

Darbepoetin alfa, epoetin alfa

These are examples of ___

colony stimulating factors

filgrastim (Neupogen), pegfilgrastim (Neulasta)

These are examples of ___

interferons used with multiple sclerosis

Interferon beta-1a (Avonex, Rebif ) ; Interferon beta-1b (Betaseron)

these are examples of ___

interleukin (used to inhibit tumor growth)

aldesleukin (Proleukin)

This is an example of ___

interleukin (used to stimulate platelet cell production

oprelvekin (Neumega)

This is an example of ___

infections and cancers

Most serious adverse effects are related to impairment in immune responses such as ___

prednisone

___ is a corticosteroid used to suppress the immune response with autoimmune disorders

cytotoxic agents

azathioprine (Imuran), infliximab (Remicade), mycophenolate (CellCept), methotrexate (Rheumatrex)

These are examples of ___

cytotoxic agents

___ suppress the immune system by killing lymphocytes (B & T) that are undergoing proliferation

Antiproliferative Agents (T cell suppressive agents)

cyclosporine (Neoral, Sandimmune), tacrilimus (Prograf)

these are examples of ___

Antiproliferative Agents (T cell suppressive agents)

___ suppress T cell proliferation

Antibody Preparations

muromonab-CD3, basiliximab, daclizumab

these are examples of ___

Antibody Preparations

___ are used to suppress allograft rejection in transplant recipients, used to treat allergic asthma not relieved with corticosteroids, and used to prevent mothers who are Rh negative from developing an immune response against Rh positive blood cells

Omalizumab (Xolair)

which antibody preparation is used to treat allergic asthma not relieved with corticosteroids

Rh0(D) Immune Globulin

which antibody preparation is used to prevent mothers who are Rh negative from developing an immune response against Rh positive blood cells

red blood cells

___ are blood cells that carry oxygen from the lungs to the body cells.

HgB < 7-8 g/dl

what is a lab finding for RBC that indicates the need for a blood transfusion

blood tubing / filter

when infusing RBC you use ___

bleeding

what is an indication for the need of platelets

whole

platelets are derived from __ blood

consent

before a blood transfusion therapy you MUST gain ___

NORMAL SALINE

when doing a blood transfusion you use ___ ONLY!

15 mins

most reactions occur within the first ___ of blood transfusion