DRUGS FOR IMMUNE SYSTEM

MODULATION CELL-MEDIATED IMMUNITY

-overwhelming infection
Lymphatic system-immune system -already infected the cell
-cytotoxic t cells-suicidal
IMMUNOMODULATOR -Apoptosis- program cell death
- drug or therapy that affects body defenses -Memory cytotoxic t cells
-stimulates body
- suppress body defenses PHARMACOTHERAPY FOR IMMUNE
SYSTEMS
Immunizations agents
IMMUNE SYSTEM
-Vaccination
✓ Life (attenuated) vaccine
INNATE (NON-SPECIFIC) BODY ✓ Inactivated killed vaccines
DEFENSES
✓ Toxoid vaccine
-first line of protection
✓ Recombinant technology vaccines
-physical barriers
-inflammation
-Immunoglobulins
- Type of body defense that is unable to
distinguish one type of threat from another.
HEPATITIS B
ADAPTIVE (SPECIFIC) BODY DEFENSES
children IM: 3 doses
-second line of protection 2nd dose after 2 months
-immune response 3rd dose after 6 months
-lymphocyte
IMMUNE GLOBULIN PREPARATIONS
ANTIGEN Active immunity
-microbes and foreign substances -own antibodies
-all pathogens are recognized -generation of memory cells

ANTIBODY Passive immunity

-immunoglobulins -transferred antibodies
-recognizes the antigen -maternal
-communicates with another defense cell -immunoglobulins for life threatening
- destruction of antigen -immunosuppressed patients
- part of the immune system that is
responsible for the recognition, MECHANISMS
communication and destruction of the
pathogen. Active
-Wait for 2 weeks to develop antibodies
HELPER T CELLS -2 weeks for memory cell
-macrophage- engulf the antigen -need booster
-helper t cell- commander-in-chief
-memory t cell- store specific code to prepare Passive
specific army for specific antigen -inject directly the antibodies
-immediate effect
HUMORAL IMMUNITY B CELLS ARE -life threatening
ALERTED
helper t cell- released cytokines IMMUNOSTIMULANTS
plasma cell- ensures for secreting antibodies -stimulate body defenses so that cancer cells
memory b cell- can be effectively attacked
 Cyclooxygenase 1
INTERFERONS
INTERFERON ALFA-2B ➢ All tissue
TC: Immunostimulant ➢ Cytoprotective
PC: Interferon
- cancer cells Cyclooxygenase 2
- pregnancy c ➢ tissue injury
➢ inflammation
IMMUNOSUPRESSANTS
➢ inflammatory
-suppress body defenses to prevent a
transplanted organ from being rejected by the
immune system
NSAID- mild to moderate
CYCLOSPORINE Corticosteroid- severe
TC: Immunosuppressant
PC: Calcineurin Inhibitors

-less toxic to bone marrow cells

Antipyretics
-soil fungus ➢ Acetaminophen
-pregnancy c

ADVERSE EFFECT
-Oliguria (low urine output) RESPIRATORY SYSTEM
Oxygen > nose/mouth > back of the
INFLAMMATION throat (trachea) > left or right lung
through bronchus > bronchioles >
Acute alveolus > capillaries
➢ Immediate onset
➢ Resole and repair
Chronic
Air into blood- diffusion
➢ Slow onset
➢ Prolonged period 300 million alveoli each lung
➢ Autoimmune 12-16 bpm
Cilla- tiny little hairs
PHARMACOTHERAY FOR Goblet cells- release mucus
INFLAMMATION
Non-Steroidal Anti-Inflammatory Drugs
(NSAIDS) UPPER RESPIRATORY TRACT

IBUPROFEN ➢ Airconditioning- warms humidifies,

clean
➢ Tissue damage ➢ Ciliated epithelium- traps and
➢ Arachidonic acid- produce sweeps
prostaglandins ➢ Dynamic structure- highly
vascularized
➢ autonomic NS
 Parasympathetic Sympathetic HISTAMINE- H1 RECEPTOR
Decrease lung Increase lung ANTAGONIST
infection infection
Dilates arterioles Constricts 1st gen
arterioles DIPHENHYDRAMINE
Produces mucus Reduces
thickness ➢ combine with analgesics,
Widens airway decongestant and expectorant
➢ minor allergy and common cold
➢ pregnancy c
Nasa Mucosa
➢ 1st line defense
➢ Rich in immunoglobulins 2nd gen
➢ Cetirizine
ANTIHISTAMINES
➢ Allergic rhinitis INTRANASAL CORTICOSTEROIDS
➢ Vertigo and mouth sickness
➢ Parkinson’s disease ✓ Perineal Allergic Rhinitis
➢ Insomnia - Continuous throughout the year
➢ Urticaria and other rashes
- 1st line in allergic rhinitis
Allergic Rhinitis
➢ decrease secretion of inflammatory
➢ Histamine- key chemical mediator mediators
➢ Plasma cell- specific antibody to ➢ metered-spray
specific antigen ➢ most effective when taken in
➢ IgE- allergen advance
o -histamine release

ADVERSE EFFECT
Therapeutic Goal
➢ Burning sensation of the nose
Preventers Relievers ➢ Drying of nasal mucosa
prophylaxis Immediate but ➢ Alternative: montelukast and
temporary ipratropium
Antihistamines Oral and nasal
decongestants
Intranasal
corticosteroids FLUTICASONE
Mast cell ➢ Perineal allergic rhinitis
stabilizer
➢ 2 sprays each nostril 2x a day
decrease to 1 dose
*nurses should identify the allergy ➢ Pregnancy c
DECONGESTANTS MYCOLYTICS
OXYMETAZOLINE - to loosen thick
PC: sympathomimetic ACETYLCESTEINE
➢ alpha adrenergic - Mucus becomes thinner
- Drug that is intended to loosen thick,
viscous bronchial secretions and to
ADVERSE EFFECT remove mucous through coughing.

➢ Rebound congestion- used longer

than 3-5 days
DRUGS FOR ASTHMA AND OTHER
➢ Resistance- switch to intranasal PULMONARY DISORDER
corticosteroids
LOWER RESPIRATORY TRACT
➢ Bring oxygen to the body
ANTITUSSIVES
➢ Respiration- gas exchange
➢ Common cold- viral infection pf URT ➢ Ventilation- moving of the air into
-Self-limiting and out
-Natural reflex ➢ Mechanical process
mechanism ➢ 12-18 bpm
-Cough= tussive ➢ Perfusion- blood flow

ANTITUSSIVES (opioids) ANS

➢ CNS Parasympathetic Sympathetic

➢ Respiratory depression Bronchoconstriction Bronchodilation
➢ Do not recommend Contraction of b- adrenergic
smooth muscle
Narrowing of the Relaxation
airway
ANTITUSSIVES (non-opioids) Produces mucus Increase airway
DEXTHREMETORPHAN
➢ Acts in medulla PULMONARY DRUGS VIA
➢ Pregnancy c INHALATION
Aerosol therapy

EXPECTORANTS AND MYCOLYTICS ➢ Suspension of minute liquid

➢ Bronchospasm
EXPECTORANT
- Increase bronchial secretion
- Reduces thickness ➢ Nebulizer- vaporizes
➢ Dry Powder Inhaler (DPI)-
GUAITENESIN inhalation of fine powder
- Most effective for dry non-productive ➢ Metered Dose Inhaler (MDI)-
cough propellant
 DISADVANTAGES ADVERSE EFFECT
- Systemic effect when swallowed - Irritation of URT
- Rinse mouth after use - Bitter taste
BRONCHODILATORS
Asthma -hereditary METHYLXANTHINES
- Acute bronchospasm
➢ Asthma- 30 yrs ago
- Intense breathlessness
-narrow safety margin
- Coughing
- Gasping for air AMINOPHYLLINE

Inflammation Bronchoconstriction THEOPHYLLINE

Inflammation cells Contraction of
Debris fill the smooth muscle
airway ANTI-INFLAMATORY DRUGS
INHALED CORTICOSTEROIDS
STATUS ASMATICUS
BECLOMETHASONE
- Prolonged asthma does not
respond to treatment - Aerosol inhalation
- Respiratory failure - Long term management
- 3-4 weeks
- Pregnancy c
- Prototype drug for inhaled
BRONCHODILATORS
corticosteroids for asthma.
BETA-ADRENERGIC AGONIST
- 1st line for acute
ADVERSE EFFECT
ALBUTEROL/ SALBUTAMOL
- Corticosteroid toxicity
- Short acting - Cataracts in adults
- Bronchospasm
- Pregnancy C
LEUKOTEREINE MODIFIERS
ZAFIRLUKAST/ MONTILUKAST
ADVERSE EFFECT
- Persistent chronic asthma
- tachycardia
- tremors

ADVERSE EFFECT
ANTICOLLIGERNICS - Headache
- Nausea
- blocks parasympathetic
- Diarrhea
IPRATOPIUM
- Pregnancy B
MAST CELL STABILIZER
Prophylaxis- prevent attack
- Inhibiting the release of histamines
- 14 days prior
CROMOLYN
NECLOCROMIL

MUNOCLONAL ANTIBODIES
OLIMAZILUMAB
➢ Anti-cancer
➢ Severe
➢ 12 yrs old below
➢ 2-4 weeks
➢ Expensive
➢ Resistant asthma