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Pharm 2 Week 1
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
1 min
Innate Immunity Barriers
Skin Protects Against Pathogens
Normal Flora Outcompete Pathogens
Lysozyme in Saliva, Tears, and Mucus
Mucous Traps Pathogens
Cilia Remove Mucus
Acid and Digestive Enzymes in the Stomach Kill Pathogens
2 mins
Humoral Adaptive Immunity
Characteristics
B Cell Binds Free Floating Antigen
B Cell Presents Antigen to Helper T Cell
Helper T Cells Help B Cells Develop Antigen Specificity
Plasma B Cells Secrete Antibodies
Memory B Cells Cause Faster Secondary Response
2 mins
Cell-mediated Adaptive Immune Response
Characteristics
Macrophages and Dendritic Cells Present Antigens
T Cell Develops Antigen Specificity
Regulatory T Cells Suppress Response
Memory T Cells Cause Faster Secondary Response
Cytotoxic T Cells Lyse Infected Cells
Infected Cells Present Antigen On Surface
2 mins
Innate Immunity Cellular Response
Characteristics
Natural Killer Lymphocytes Attack Abnormal Cells
Neutrophils in Blood
Infected Cells Release Interferon
Complement Proteins Lyse Pathogens/Infected Cells
Dendritic Cells in Tissue
Macrophages in Tissue
2 mins
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
2 mins
Live Attenuated Vaccines
Characteristics
Humoral and Cellular Immune Response
May Revert to Virulent Form
Do Not Require Boosters
Vaccines
Varicella (Chickenpox)
Zoster (Shingles)
Polio (Sabin)
Smallpox
Yellow Fever
Influenza (Intranasal)
MMR
Rotavirus
Typhoid Fever (Oral)
BCG (Bacillus Calmette-Guérin)
4 mins
Killed (Inactivated) Whole Vaccines
Characteristics
Require Booster Shots
Vaccines
Mostly Humoral Immune Response
Polio (Salk)
Rabies
Cholera
Hepatitis A
54 secs
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
2 mins
Toxoid Vaccines
Consist of Toxins Released From a Pathogen
May Require Boosters
Safe In Immunocompromised Patients
Corynebacterium Diphtheriae Vaccine
Tetanus Vaccine
Bordetella Pertussis Vaccine
2 mins
Human Papillomavirus (HPV)
Characteristics
Non-enveloped
Circular
Double Stranded DNA
Disease
Warts 1, 2, 6, 11
Condyloma acuminata
Type 16, 18
Cervical Carcinoma
Penile Carcinoma
AIDS/Immunocompromised
Worsened by Smoking
Diagnosis
Koilocytic change in squamous epithelium
Pyknotic Nuclei Surrounded by Clear Halo
Treatment
Vaccine Available
4 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
2 mins
Pediatric Vaccinations Age 4-6 Years
Very DIM between 4-6pm
Varicella Zoster
DTaP - Diphtheria Tetanus acellular pertussis
IPV - Inactivated Polio Vaccine
MMR
1 min
Rubella
Mechanism
Rubella Virus
Signs and Symptoms
Swollen Glands
Cold-like Symptoms
Pinkish-red Maculopapular Rash
Low Grade Fever
Considerations
Rubella Titer
Avoid Contact with Pregnant Women
MMR Vaccination
2 mins
Pediatric Vaccinations - Age 12 to 15 Months
1 Very MAD HIP-ster
Varicella Zoster
MMR
Hepatitis A
DTaP - Diphtheria Tetanus acellular pertussis
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
2 mins
Influenza Virus
Characteristics
RNA Virus
Orthomyxovirus
Enveloped
Negative Sense
8 Segments
Helical
Hemagglutinin for Viral Entry
Neuraminidase for Virion Release
Genetic Shift
Reassortment of genome to cause major change
Genetic Drift
Minor Antigenic Mutations
Considerations
Reye Syndrome with Aspirin Use
Guillain-Barre Syndrome
3 mins
Pediatric Vaccinations - Age 2 Months
2 B DR HIP
Hepatitis B
DTaP - Diphtheria Tetanus acellular Pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
1 min
Pediatric Vaccinations - Age 4 Months
4 DR HIP
DTaP - Diphtheria Tetanus acellular pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
1 min
Haemophilus Influenzae Disease
Disease
Pneumonia
Cherry Red Epiglottitis
Meningitis
Otitis Media
COPD Exacerbation
Thumbprint Sign (on X-ray)
Treatment
Rifampin Prophylaxis
Ceftriaxone
2 mins
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