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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 - PowerPoint PPT Presentation
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CHAPTER 46CHAPTER 46
Immunizing Drugs andImmunizing Drugs and Biochemical Terrorism Biochemical Terrorism
04/22/23 1Winter 2013
IMMUNITY
Immune response… Antigens
… Antibodies
Active immunization Passive immunization
04/22/23 2Winter 2013
IMMUNIZING BIOLOGICALS
Biological antimicrobial agents… Also called biologicals
… Used to prevent, treat, or cure infectious diseases
Antitoxins
Antisera
Toxoids and vaccines (immunizing biologicals)
04/22/23 3Winter 2013
TOXOIDS
Antigenic (foreign) preparations of bacterial exotoxins
Detoxified with chemicals or heat… Weakened or “attenuated”
Cannot revert back to a toxic form
04/22/23 4Winter 2013
TOXOIDS (CONT’D)
Stimulate one’s immune system to produce a specific antibody… Artificial active immune response
These antibodies protect against future exposures
04/22/23 5Winter 2013
VACCINES
Suspensions of live, attenuated (weakened) or killed (inactivated) microorganisms
The weakened form prevents the person from contracting the disease
04/22/23 6Winter 2013
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
04/22/23 7Winter 2013
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
04/22/23 8Winter 2013
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
04/22/23 9Winter 2013
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
04/22/23 10Winter 2013
ACTIVE IMMUNIZING DRUGS: EXAMPLES (CONT’D)
Smallpox virus vaccine Tetanus toxoid Varicella virus vaccine
(chickenpox) Yellow fever virus vaccine Many others
04/22/23 11Winter 2013
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
04/22/23 12Winter 2013
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
04/22/23 13Winter 2013
PASSIVE IMMUNIZING DRUGS
Antitoxins Immunoglobulins Snake and spider antivenins
(antivenom)
04/22/23 14Winter 2013
PASSIVE IMMUNIZING DRUGS: EXAMPLES
Antivenins… Pit viper, coral snake
… Black widow spider
Hepatitis B immune globulin Immunoglobulin, various
forms Rabies immunoglobulin
(human)
04/22/23 15Winter 2013
PASSIVE IMMUNIZING DRUGS: EXAMPLES (CONT’D)
Rho(D) immune globulin (RhoGAM)
Tetanus immunoglobulin
04/22/23 16Winter 2013
INDICATIONS
Active immunization… Prevents infection caused by
bacterial toxins or viruses
… Provides long-lasting or permanent immunity
… “Herd immunity”
04/22/23 17Winter 2013
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)
04/22/23 18Winter 2013
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
04/22/23 19Winter 2013
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
04/22/23 20Winter 2013
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)
04/22/23 21Winter 2013
NURSING IMPLICATIONS
Assess previous reactions and responses to immunizations
Assess for contraindications, including immunosuppression
04/22/23 22Winter 2013
NURSING IMPLICATIONS (CONT’D)
Before giving any drug, recheck the specific protocols for administration and schedules for administration
04/22/23 23Winter 2013
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
04/22/23 24Winter 2013
ILLNESSES CAUSED BY POSSIBLE BIOTERRORISM AGENTS
Anthrax Smallpox Botulism Tularemia Viral hemorrhagic fever Plague
04/22/23 25Winter 2013
POSSIBLE BIOTERRORISM AGENTS
Sarin (nerve gas) Mustard (blistering agent) Cyanide (blood agent) Chlorine (choking agent) Radioactive elements Ricin
04/22/23 26Winter 2013