Drugs Affecting the Immune System

Immunomodulators- a general term referring to any drug or therapy that affects the body defenses. It can either be a stimulant or a suppressant.
Types:
a. Immunization drugs
b. Immunostimulants
c. Immunosuppressant
Types
Immunizing agent
Vaccines
- are biological
agents used to
stimulate the
immune system.
Vaccination
- is the process of
introducing
foreign protein or
inactive cells into
the body to
trigger immune
activation before
the patient is
exposed to real
pathogens
- Goal is to
produce a
lifelong immunity
without
producing illness
in an otherwise
healthy person.

Mechanism of action
a. Attenuated (live) vaccines
- Contained microbes that
are alive but weakened
so they are unable to
produce disease not
unless the person is
immunoincompetent.
- Ex: MMR
b. Inactivated (killed)
- The microbes are
inactivated by heat or
chemical and are unable
to replicate or cause
disease
- Ex: influenza and Hep A.
c. Toxoids
- Contained bacterial
toxins that have been
chemically modified to
incapable of causing
disease
- Ex: Diphtheria and TT
d. Recombinant technology
vaccines
- Contains partial
organism or bacterial
proteins that are
generated in the
laboratory using
biotechnology.

Indication
Prophylaxis and
prevention of
Immunizable
diseases

Contraindication
a. Live vaccines are CI
among clients who are
imunodifficient.
b. Pregnancy
c. Those who receive
immunoglobulins or
blood products within 3
months
d. Severe allergic reaction
e. Caution:
Febrile convulsion
Acute infection
f. Drug interaction
Should not be given
with any
immunosuppressant
drugs including
corticosteroid.

Adverse Effects
Please refer to:
Table 67-4
Lehne, R., 2010.
Pharmacology for
Nursing Care. 7th ed.
Missouri: Elsevier.
pp. 2242

Nursing responsibility
Please fill this column
base on your own
readings.

- Ex. Hep B.
Examples:
Please refer to:
Table 67-3
Lehne, R., 2010.
Pharmacology for Nursing
Care. 7th ed. Missouri:
Elsevier.
pp. 2240-2241
Immune Sera
- These drugs
contains specific
antibodies to
bacteria or
viruses
- Antitoxinantibodies for
specific toxins
- Antiveninantibodies for
venom

It gives the body passive

immunity by introducing
specific antibodies

Immunestimulants
a. Interferonusually released
in response to
viral infections
b. Interleukinproduced by Tcells to
communicate
between
leukocytes

Interferon
- Prevents virus particles
form replicating inside the
cell
- Stimulate the interferon
receptor sites on noninvaded cells to produced
antiviral proteins which
prevent the virus from
entering the cells
- Inhibit growth factor and
replication and stimulate
cytotoxic T-cells activity.

Examples:
a. varicella-zoster
immune globulin

Examples:
Interferon alpha2b (Intron-A)

a. Prophylaxis against
disease after
exposure
b. Gives quick
immunity to
prevent potential
debilitating effect
of the disease.

a. Severe reaction to any

immune sera
b. Cautiously among
pregnant
c. Coagulation defect or
thrombocytepenia

a. Rash, vomiting and

nausea
b. Allergic responses
(chest tightness,
SOB and decrease
BP)
c. Local reaction:
swelling, redness
and pain.

a.Viral infection and

malignant
neoplasm
Hepatitis B and C
AIDs related
complexes (Kaposi
sarcoma)
Multiple sclerosis
Granulomatous
disease

a. Allergies to interferon
b. Teratogenic to animals
(CI to pregnant)
c. CI among lactating
d. Caution:
- Cardiac disease
- Myelosuppression
- CNS dysfunction

a.Inflammatory
related: flu-like
syndrome such as
lethargy, myalgia,
arthralgia
b. Bone marrow
suppression,
depression, suicidal
ideation and
photosensitivity.

Interferon alfacon 1 (Infergen)

Pefinterferon alpha2a
(Pregasys)
Peginterferon alpha 2b (PegIntron)
Interferon beta 1b (Betason)

Immunosuppressants
a. T and B cells
suppressors
b. Interleukin
receptor
antagonist
c. Monoclonal
antibodies

Interleukins
- It communicates between
lymphocytes which
stimulates the cellular
immunity and inhibit
tumor growth
- Interleukins 2 stimulates
cellular immunity by
increasing the activity of
natural killer cells, platelet
and cytokines.
Examples:
Aldasleukin (Proleukin)
Oprelvekin (Neumega)

neoplasm

a. Allergies to E-coli or
interleukins
b. Embryocydal and
teratogenic to animals
c. Not recommended to
lactating mothers
d. Caution:
- Renal and liver
problem
- Cardiovascular disease

a. Inflammatory likeflu-like, lethargy,

myalgia, arthralgia,
fatigue and fever.
b. CNS changes and
cardiac
arrhythmias.

T and B cells Suppressors

- Unknown but believes to
block antibody production
by B-cells and inhibiting
suppressor and T helper
cells.
Examples:
cyclosporine (Neoral)
azathioprine (Imuran)
mycophenolate (Cellcept)
tacrolinus (Prograft)

a. Prevention and
treatment of
transplant
rejection

a. Allergies to medication,
pregnancy and lactation
b. Known neoplasm
c. Used cautiously with
hepatic and renal
impairment

a. Increase risk of
infection and
development of
neoplasm
b. Hepatotoxicity and
nephrotoxicity.
c. Secondary infection

Interleukin-Receptor
Anatgonist
- Blocks by antagonizing the
activation of interleukin I
that is released in an
inflammatory or immune

a.Rheumatoid
arthritis

a. Allergies to known E-coli

products and anakinra
itself
b. Immunosuppressed,
renal impairment and
active infection

a. Nausea, diarrhea
and URTI

response
Examples:
anakinra (Kineret)

Monoclonal Antibodies
Please fill up this portion base
on your own readings.

c. Cautiously among
pregnant and lactating
mothers
d. Drug Interaction:
- etanercept (Enbrel)CI for it can cause
potential fatal
infection.