Immunomodulators & Immunosuppressants - Chapter 32 Flashcards
(54 cards)
1
Q
Immunization
A
- Deliberate, artificial exposure to a disease to produce acquired immunity
- Achieved by administering vaccines
2
Q
Vaccines
A
- Prevent disease by taking advantage of the body’s ability to make antibodies
- an altered antigen that is injected or introduced into the body
- Provide protection against the disease should the patient be exposed to it again
3
Q
Types of Vaccines
A
- Live, attenuated
- Inactivated, killed
- Toxoid
- Conjugate
4
Q
Live, Attenuated Vaccines
A
-Live but weakened version of disease will NOT cause disease in a healthy individual
5
Q
Inactivated, Killed Vaccines
A
-Produce less immunity so may need booster
6
Q
Toxoid Vaccines
A
e.g. tetanus and diphtheria
7
Q
Conjugate Vaccines
A
e.g. Haemophilus influenzae type B (Hib) vaccine
8
Q
Influenza Vaccine
A
Flumist
-im or nasal mist
9
Q
Shingles Vaccine
A
Zostavax, Zostavax II, Shingrix
- Zostavax must be kept in freezer
- Zostavax II must be kept in fridge
10
Q
Hepatitis A (inactivated) Vaccines
A
- Havrix
- Vaqta
- Epaxal
- Avaxim
- Avaxim Pediatric
11
Q
Hepatitis B (inactivated) Vaccines
A
- Engerix B
- Engerix B periatric
- Recombivax
- Doses at 0, 1 and 6 mo. intervals
- Accelerated doses at 0, 7, 21 days
12
Q
Hepatitis A and B Vaccines
A
- Twinrix (720)
- Twinrix Jr (360)
13
Q
Rotavirus Vaccine
A
Rotateq
14
Q
HPV Vaccines
A
- Gardasil (HPV 6, 11, 16, 18)
- Cervarix (HPV `16, 18)
15
Q
Dukoral
A
-Used for prevention of travelers diarrhea due to E. coli
16
Q
The Cold Chain
A
-A set of safe handling practices that ensure vaccines and immunologicals requiring refrigeration are maintained at the required temperature
17
Q
Why Cold Storage is Important
A
- Disruption of the cold chain is a public health threat
- When the cold chain is disrupted, the effectiveness and shelf-life of vaccines are reduced
- Once integrity of vaccine is compromised, it cannot be restored
18
Q
Cold Chain Maintenance
A
- Refrigeration temperature should be between 2 and 8 degrees Celsius
- If the fridge is overstocked, air circulation is insufficient to maintain constant temperatures
- Fridge should contain min/max thermometer to monitor temp.
- Monitors and thermometers should be calibrated
- alarm
- Door lock
- Record temp. regularly throughout the day
19
Q
Protocols For Receiving, Stocking, and Storage
A
- Protocols should include accurate assessment of condition of vaccines
- Employees should be alert for warning signs that the cold chain has been broken
- Ensure vaccines are rotated
- Expiry dates checked
- Do not remove vaccines from fridge until the time of dispensing or transport
20
Q
Warning Signs the Cold Chain Has Been Broken During Shipment
A
- Freezer packs are melted
- Dry ice has evaporated
21
Q
Protocols for Transport
A
- Pharmacy personnel in charge of transport are responsible for making sure the vaccines arrive at their destination at the proper temp.
- Vaccine out of fridge for <20 min, insulated bag. >20 min, ice packs
- Vaccines should be transported in an insulated container
- Vaccines should avoid direct contact with ice packs
- Heat and cold monitors should be included in transport container
22
Q
Dispensing Cold Vaccines
A
- Vaccines should never be placed in hot glove compartment of car
- Travel time <20 min, insulated bag
- Travel time >20 min, ice packs in insulated container
- Label- REFRIGERATE; DO NOT FREEZE
23
Q
Immunosuppressants
A
-Inhibit the immune system
24
Q
Cyclosporine
A
- Produced by a fungus
- Suppresses cell destruction and prevents organ transplant rejection
- Acts on T-lymphocyte cells
25
Generic: cyclosporine
Neoral, Sandimune
26
cyclosporine ADR's
- increased risk for infections
- Acne
- Diarrhea
- Leg cramps
- Headache
- Anorexia
- Nausea/Vomiting
27
Cyclosporine Warning Labels
- AVOID PREGNANCY
- AVOID GRAPEFRUIT JUICE
- DO NOT REFRIGERATE
- ORAL SOLUTION MUST BE USED WITHIN 2 MONTHS OF OPENING
- DISCARD DISCOLORED OR CLOUDY SOLUTION FOR INJECTION
28
Macrolides
- Common ending: "limus"
| - Inhibit enzyme involved in gene transcription of interleukins, interferons, and cytokines
29
Generic: sirolimus
Rapamune
Warning Labels:
- AVOID RAPEFRUIT JUICE
- AVOID CONTACT WITH SKIN
- REFRIGERATE; DISCARD WITHIN 30 DAYS OF OPENING
30
Generic: tacrolimus
Prograf, Protopic, Advagraf
Warning Labels:
- AVOID GRAPEFRUIT JUICE
- TAKE ON AN EMPTY STOMACH
31
Macrolides ADR's
- Diarrhea or constipation
- Nausea/vomiting
- Dizziness
- Headache
- Confusion
- Loss of appetite
- Hair loss or growth
- Depression/mood changes
- Seizures
- Tremor
32
Mycophenolate Mofetil
-Used with corticosteroids and cyclosporine to decrease rejection of transplanted organs
33
Generic: mycophenolate mofetil
CellCept, Myfortic
34
mycophenolate mofetil ADR's
- Constipation or diarrhea
- GAs
- Loss of appetite
- Nausea, vomiting, stomach pain, etc.
- Increased risk of bacterial/viral infections
- Leukopenia
35
mycophenolate mofetil Warning Labels
- TAKE ON EMPTY STOMACH
| - STORE RECON. SOLUTION AT ROOM TEMP AND DISCARD IN 60 DAYS
36
Immunomodulators
- Chemical agent that modifies the immune response or the functioning of the immune system
- Monoclonal antibodies
- Antithymocyte globulin (ATG)
- Intravenous y-immune globulin
- Rho(D) immune globulin
- T-cell costimulation blocker
37
Monoclonal Antibodies
- Common ending: "mab"
| - Used to reduce transplant rejection and prolong life of transplanted organs
38
Generic: basiliximab
Simulect
Warning Labels:
-SOLUTION SHOULD BE USED WITHIN 4 HOURS OF PREPARATION
39
Monoclonal Antibodies Warning Labels
`-REFRIGERATE; DONT FREEZE
- PROTECT FROM LIGHT
- DO NOT SHAKE
40
Antithymocyte Globulin (ATG)
-Administered to reduce rejection associated with organ and bone marrow transplant
41
Generic: antithymocyte globulin
Atgam, Thymoglobulin
42
Antithymocyte Globulin ADR's
- Fever and chills
- Dizziness
- Leukopenia
- Skin rash
- Headache
- Tiredness
- Diarrhea
43
Antithymocyte Globulin Warning Labels
- GENTLY ROTATE SOLUTION; DO NOT SHAKE
| - REFRIGETARE DILUTED SOLUTION
44
Intravenous y-immune Globulin
-Used for treatment of a variety of infections and chronic lymphatic leukemia
45
Generic: immunoglobulin IV
Vivaglobulin
46
Immunoglobulin IV ADR's
- Nausea and stomach pain
- Headache
- Redness, itching at site of infusion
- Chest pain
- Dyspnea
47
Rho (D) Immune Globulin
-Administered tro pregnant women who are Rh(-) and have been exposed to blood that is Rh(+)
48
Generic: Rho immune globulin
WinRho
49
Rho Immune Globulin ADR's
- Headache
- Muscle aches and pains
- Pain and tenderness at injection site
- Chills, fever, and allergic reactions
- Dizziness
50
Rho Immune Globulin Warning Labels
- REFRIGERATE; DO NOT FREEZE
| - PROTECT FROM LIGHT
51
Cytokine inhibitors and Tumor Necrosis Factor-a Inhibitors
- anakinra
| - etanercept
52
Generic: anakinra
Kineret
53
Generic: etanercept
Enbrel
54
Cytokine inhibitors and Tumor Necrosis Factor-a Inhibitors Warning Labels
- PROTECT FROM LIGHT
| - REFRIGERATE; DO NOT FREEZE
