Immune System
Antigen
- Substances the body recognizes as foreign that illicit an immune response
Antibody
- Immunoglobulins produced by B lymphocytes (plasma cells) in response to
antigens
Characteristic Active Passive
Definition Exposure of the body to The host is given the
the associated antigen ability to fight off the
invading microorganism
Type of immunizing drug Toxoid or vaccine Immunoglobulin or
antitoxin
Artificial Exposure to vaccine Man made Antibodies
(flu, herpes zoster, already prepared for host
chickenpox, rubella) à (Hep B, rabies, tetanus,
making antibodies from varicella)
lab
Natural Immunity by surviving Mom to baby via
the disease (making breastmilk or blood
antibodies from getting stream via placenta (Not
sick) made in lab)
,Cell Mediated Immunity
- Bone marrow produces T lymphocytes à T lymphocytes mature in thymus
gland à split to become either T helper cells OR Cytotoxic T cells (T-
killer)
- Defends against intracellular pathogens and abnormal cells
Humoral Immunity
- Bone marrow produces B lymphocytes à made into antibodies
- Antibodies circulating in blood and binds to antigens on bacteria and viruses
Humoral Cell Mediated
- Antigen binds to B lymphocytes - T lymphocytes
- B lymphocytes differentiate into - T cytotoxic cells (CD8) kills
plasma cells that make antigen directly
antibodies and memory cells - T helper cells (CD4) directs the
that remember antigen action of other immune cells and
- (BONE MARROW à messengers (cytokines à
PLASMA CELLS à chemical messengers)
ANTIBODIES)
- Antigen antibody complex - Macrophages, natural killer cells
renders the antigen inactive and neutrophils
Antibiotic Resistance
- Bacteria produce enzymes that destroy or inactivate the drugs
- Drugs target sites become altered so the antibiotic cannot bind to enter the
bacteria
- If drug cannot enter the cell it cannot kill the bacteria
• MRSA
• VRE
• ESBLS
• CRE
,Antibiotic Therapy
- Empiric
• Treating before getting cultures back with best guess
• “guessing” broad spectrum (ear infections, respiratory infections)
- Definitive
• Tailored to treat organism identified with cultures (narrow spectrum)
• ALWAYS CULTURE BEFORE STARTING ANTIBIOTICS
- Prophylactic
• P = prevent
• To prevent infection, before surgery / after trauma
- Combination
• Transplant, valve replacement
• Provides additive effects used with severe infections
Superinfections
- Opportunistic à overgrowth of normal flora
- C diff à increase dairy to prevent
Considerations
- ALL antibiotics…
• Interact with OCPs
• Causes increased anticoagulation effect if taking warfarin (decrease
Vit K à increase circulating warfarin à increase anticoagulation à
increase bleed risk)
- NO ALCOHOL
- Take on empty stomach (macrolides, tetracyclines, fluroquinolones)
- Stay out of sunlight (fluroquinolones, tetracyclines, sulfas)
- Super toxic to kidneys and ears (nephrotoxic à BUN > 20, Creatinine
<1.3, UO < 30mL / hr, ototoxic à tinnitus, vertigo, ataxia, hearing loss)
à Vancomycin Gentamycin, Neomycin
- NO tetracyclines for infants / young children
, Antibiotic Classes
Bactericidal Drugs
Penicillin’s
- Indication: broad spectrum
- MOA : Bactericidal
- Contraindications: Allergies, use carefully with renal insufficiency
- ADE: kidney function, maculopapular rash, Steven Johnson Syndrome,
hives, renal impairment
- Interactions: methotrexate, OCP, Warfarin (bleeding)
- Special Things: take on empty stomach OR with 8oz of water, monitor
for allergy, use 2nd form of BC, tale full dose
Anaphylaxis à monitor for rash, angioedema, hypoxia, low BP, increase
HR, resp depression
Cephalosporins
- ***Penicillin and Cephalosporins are cousins, if allergic to one PROBABLY
allergic to the other***
- Indication: broad spectrum
- MOA: Bactericidal
- Contraindications: Allergy, cross sensitivity with Penicillin, renal
impairment, bleeding
- ADE: rash, diarrhea, cramps
- Interactions: Alcohol, antacids, iron (take separately), OCPs, warfarin
- Special Things: Assess allergy, no alcohol up to 72 hrs, 4 generations
Antigen
- Substances the body recognizes as foreign that illicit an immune response
Antibody
- Immunoglobulins produced by B lymphocytes (plasma cells) in response to
antigens
Characteristic Active Passive
Definition Exposure of the body to The host is given the
the associated antigen ability to fight off the
invading microorganism
Type of immunizing drug Toxoid or vaccine Immunoglobulin or
antitoxin
Artificial Exposure to vaccine Man made Antibodies
(flu, herpes zoster, already prepared for host
chickenpox, rubella) à (Hep B, rabies, tetanus,
making antibodies from varicella)
lab
Natural Immunity by surviving Mom to baby via
the disease (making breastmilk or blood
antibodies from getting stream via placenta (Not
sick) made in lab)
,Cell Mediated Immunity
- Bone marrow produces T lymphocytes à T lymphocytes mature in thymus
gland à split to become either T helper cells OR Cytotoxic T cells (T-
killer)
- Defends against intracellular pathogens and abnormal cells
Humoral Immunity
- Bone marrow produces B lymphocytes à made into antibodies
- Antibodies circulating in blood and binds to antigens on bacteria and viruses
Humoral Cell Mediated
- Antigen binds to B lymphocytes - T lymphocytes
- B lymphocytes differentiate into - T cytotoxic cells (CD8) kills
plasma cells that make antigen directly
antibodies and memory cells - T helper cells (CD4) directs the
that remember antigen action of other immune cells and
- (BONE MARROW à messengers (cytokines à
PLASMA CELLS à chemical messengers)
ANTIBODIES)
- Antigen antibody complex - Macrophages, natural killer cells
renders the antigen inactive and neutrophils
Antibiotic Resistance
- Bacteria produce enzymes that destroy or inactivate the drugs
- Drugs target sites become altered so the antibiotic cannot bind to enter the
bacteria
- If drug cannot enter the cell it cannot kill the bacteria
• MRSA
• VRE
• ESBLS
• CRE
,Antibiotic Therapy
- Empiric
• Treating before getting cultures back with best guess
• “guessing” broad spectrum (ear infections, respiratory infections)
- Definitive
• Tailored to treat organism identified with cultures (narrow spectrum)
• ALWAYS CULTURE BEFORE STARTING ANTIBIOTICS
- Prophylactic
• P = prevent
• To prevent infection, before surgery / after trauma
- Combination
• Transplant, valve replacement
• Provides additive effects used with severe infections
Superinfections
- Opportunistic à overgrowth of normal flora
- C diff à increase dairy to prevent
Considerations
- ALL antibiotics…
• Interact with OCPs
• Causes increased anticoagulation effect if taking warfarin (decrease
Vit K à increase circulating warfarin à increase anticoagulation à
increase bleed risk)
- NO ALCOHOL
- Take on empty stomach (macrolides, tetracyclines, fluroquinolones)
- Stay out of sunlight (fluroquinolones, tetracyclines, sulfas)
- Super toxic to kidneys and ears (nephrotoxic à BUN > 20, Creatinine
<1.3, UO < 30mL / hr, ototoxic à tinnitus, vertigo, ataxia, hearing loss)
à Vancomycin Gentamycin, Neomycin
- NO tetracyclines for infants / young children
, Antibiotic Classes
Bactericidal Drugs
Penicillin’s
- Indication: broad spectrum
- MOA : Bactericidal
- Contraindications: Allergies, use carefully with renal insufficiency
- ADE: kidney function, maculopapular rash, Steven Johnson Syndrome,
hives, renal impairment
- Interactions: methotrexate, OCP, Warfarin (bleeding)
- Special Things: take on empty stomach OR with 8oz of water, monitor
for allergy, use 2nd form of BC, tale full dose
Anaphylaxis à monitor for rash, angioedema, hypoxia, low BP, increase
HR, resp depression
Cephalosporins
- ***Penicillin and Cephalosporins are cousins, if allergic to one PROBABLY
allergic to the other***
- Indication: broad spectrum
- MOA: Bactericidal
- Contraindications: Allergy, cross sensitivity with Penicillin, renal
impairment, bleeding
- ADE: rash, diarrhea, cramps
- Interactions: Alcohol, antacids, iron (take separately), OCPs, warfarin
- Special Things: Assess allergy, no alcohol up to 72 hrs, 4 generations
