Baldwin Exam 1: Immunology Overview

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Questions and Answers

What is the primary function of B cells in adaptive immunity?

To produce antibodies specific to pathogens (correct)

To directly kill infected cells

To enhance the innate immune response

To regulate the immune response

Which vaccine type uses a weakened version of a pathogen?

Toxoid vaccine

Live vaccine (correct)

Inactivated vaccine

Subunit vaccine

How does cyclosporine function in the context of organ transplants?

It boosts the innate immune response

It acts as an immunosuppressant affecting only B cells

It enhances T cell activity to fight pathogens

It inhibits T cell function to prevent organ rejection (correct)

Which immunoglobulin is most abundant in the body and associated with long-term immunity from vaccines?

IgG Signup and view all the answers

Why must steroids be tapered off slowly?

To reduce the risk of immune system rebound Signup and view all the answers

What potential side effect can occur from long-term steroid use?

Hyperglycemia Signup and view all the answers

What is the effect of Ergotamine in pregnant patients?

It can cause death to the fetus. Signup and view all the answers

What type of anesthesia does NOT result in loss of consciousness?

Local anesthesia Signup and view all the answers

Which of the following statements about Lidocaine is true?

It can interact dangerously with St John's Wort. Signup and view all the answers

What is the primary purpose of adding Epinephrine to local anesthetics?

To keep the anesthetic localized. Signup and view all the answers

What is the first stage of General Anesthesia characterized by?

Loss of pain with retained awareness. Signup and view all the answers

What is NOT a common adverse effect of local anesthesia?

Increased sensitivity to pain Signup and view all the answers

What should patients do prior to undergoing general anesthesia?

Fast for at least two hours. Signup and view all the answers

Which of the following describes a 'nerve block'?

Injection targeting specific nerves to block sensation. Signup and view all the answers

What is the common mechanism by which most local anesthetics operate?

Blocking sodium ion entry into neurons. Signup and view all the answers

What is the primary function of helper T cells in the immune response?

Activate other immune cells Signup and view all the answers

Which type of immunity is provided by transferring pre-formed antibodies from one individual to another?

Passive immunity Signup and view all the answers

What is the primary purpose of the Complement System in the immune response?

To enable the body to localize and destroy pathogens Signup and view all the answers

Which stage of anesthesia involves the patient becoming delirious and the heart rate becoming irregular?

Stage 2 Signup and view all the answers

What is the primary therapeutic action of interferons (IFNs) in the immune system?

Enhance phagocytosis and cytotoxic activity Signup and view all the answers

What is the function of T lymphocytes in the adaptive immune response?

To perform cell-mediated immunity and aid in antibody production Signup and view all the answers

Which adverse effect is associated with prolonged use of interferon alfa-2b?

Immunosuppression Signup and view all the answers

Which type of vaccine contains weakened microbes and can potentially cause disease in immunocompromised individuals?

Attenuated (Live) vaccines Signup and view all the answers

What should be done before administering a vaccine to an individual?

Check the individual’s temperature Signup and view all the answers

What is a significant concern when administering cyclosporine as an immunosuppressant?

Increased risk of malignancies and infections Signup and view all the answers

What is the significance of the half-life of nitrous oxide?

It determines how long the drug will be effective Signup and view all the answers

Which of the following leukocytes is most abundant in the human body?

Neutrophils Signup and view all the answers

What is a critical nursing consideration when administering ibuprofen?

Monitor for signs of renal failure Signup and view all the answers

What is the primary role of macrophages in the immune response?

Phagocytize antigens and present them to lymphocytes Signup and view all the answers

Which of the following should be avoided when taking acetaminophen?

Using other hepatotoxic medications Signup and view all the answers

What happens in Stage 4 of anesthesia?

The medulla oblongata becomes paralyzed, leading to possible cardiac arrest Signup and view all the answers

What is the role of cytotoxic T cells in the immune system?

To directly kill infected or cancerous cells Signup and view all the answers

Which immunoglobulin is primarily involved in allergic reactions and combating parasitic infections?

IgE Signup and view all the answers

What is a significant risk associated with the use of morphine as an opioid analgesic?

Respiratory depression Signup and view all the answers

Which type of pain is primarily treated with opioid medications like morphine?

Severe acute pain Signup and view all the answers

Which of the following is NOT a major receptor type targeted by opioids for pain management?

Gamma receptors Signup and view all the answers

What potential side effect can lead to restrictions when prescribing ibuprofen, especially in patients with specific health conditions?

Impaired kidney function Signup and view all the answers

Which medication requires confirmation of non-pregnancy in women before administration due to its potential harmful effects?

Ergotamine Signup and view all the answers

What is the mechanism of action of naloxone in reversing opioid overdose?

It antagonizes mu and kappa receptors Signup and view all the answers

What common side effect is associated with opioid use that can severely impact patient quality of life?

Severe constipation Signup and view all the answers

What effect do immunomodulators like cyclosporine have on T cells?

They suppress the function of T cells. Signup and view all the answers

Which characteristic is true of inactivated vaccines compared to live vaccines?

They cannot cause infection from the vaccine. Signup and view all the answers

Which immunoglobulin type is primarily involved in allergy responses?

IgE Signup and view all the answers

What is a key consideration when administering live vaccines?

They must not be given to infants or immunosuppressed patients. Signup and view all the answers

What potential side effect is associated with the use of steroids in patients?

Hyperglycemia Signup and view all the answers

What type of vaccine is used to evoke passive immunity against pathogens like tetanus and rabies?

Toxoid vaccines Signup and view all the answers

What is the expected result of administering Ergotamine to a pregnant patient?

Severe fetal complications leading to death Signup and view all the answers

Which of the following statements accurately describes local anesthesia?

It can affect both sensory and motor functions. Signup and view all the answers

What is a common adverse effect associated with local anesthesia?

Respiratory depression Signup and view all the answers

What mechanism allows Lidocaine to block pain perception?

Blocking sodium ion entry into neurons Signup and view all the answers

Which of the following best describes General Anesthesia?

Results in total analgesia and loss of consciousness. Signup and view all the answers

What role does Epinephrine play when added to local anesthetics?

Decreases the potential for systemic toxicity by constricting blood vessels. Signup and view all the answers

What is the effect of local anesthetics when they enter systemic circulation?

Potential systems-wide adverse effects. Signup and view all the answers

Which statement about the stages of General Anesthesia is accurate?

Stage 1 may still involve a conscious state. Signup and view all the answers

What is a key consideration for patients prior to undergoing General Anesthesia?

They should remain NPO for at least 2 hours before surgery. Signup and view all the answers

Which statement accurately describes a risk associated with opioid administration?

Opioids may cause significant respiratory depression, especially in opioid-naive patients. Signup and view all the answers

What mechanism do COX-2 inhibitors utilize to provide therapeutic effects in pain management?

Inhibition of the synthesis of inflammatory prostaglandins. Signup and view all the answers

Which of the following is a possible side effect of using sumatriptan for migraine treatment?

Vasoconstriction possibly causing chest pain. Signup and view all the answers

What characteristic differentiates acute pain from chronic pain?

Chronic pain results in a gradual onset and long-term management needs. Signup and view all the answers

Which medication is contraindicated for use in pregnant women due to its high risk of fetal harm?

Ergotamine, known for its category X classification. Signup and view all the answers

What effect does naloxone have when administered to a patient experiencing an opioid overdose?

It reverses opioid effects and may induce withdrawal symptoms. Signup and view all the answers

Which medication is most likely to cause gastrointestinal discomfort as a common side effect?

Ibuprofen, known for its gastrointestinal impacts. Signup and view all the answers

What is the function of succinylcholine in the context of anesthesia?

Induces paralysis without loss of consciousness Signup and view all the answers

Which immunoglobulin is primarily responsible for mucosal immunity and secretions?

IgA Signup and view all the answers

Which pathway of the complement system is activated by antibodies?

Classical Pathway Signup and view all the answers

What is the role of myelocytes in innate immunity?

Engulf foreign cells Signup and view all the answers

What does the presence of interleukins indicate in the immune response?

Communication between leukocytes Signup and view all the answers

Which type of vaccine requires follow-up doses to maintain immunity?

Inactivated (killed) vaccines Signup and view all the answers

Which cells in the immune system are primarily responsible for cell-mediated immunity?

T lymphocytes Signup and view all the answers

In which stage of anesthesia is the patient at risk of paralysis of the medulla oblongata?

Stage 4 Signup and view all the answers

What is the primary function of macrophages in the immune response?

Detect and destroy pathogens Signup and view all the answers

What mechanism is primarily used by nitric oxide in pain suppression?

Suppressing pain mechanisms in the CNS Signup and view all the answers

What is a significant potential complication of prolonged therapy with interferon alfa-2b?

Hepatotoxicity Signup and view all the answers

Why should immunostimulants not be given to individuals with autoimmune disorders?

They can exacerbate existing autoimmune conditions. Signup and view all the answers

Which of the following agents is primarily indicated for the inhibition of prostaglandin synthesis?

Aspirin Signup and view all the answers

What is a main reason to avoid administering cyclosporine with grapefruit juice?

It raises drug levels by 50-200%, increasing toxicity. Signup and view all the answers

What are the primary actions of interleukins in the immune system?

Enhance T-cell and plasma cell production. Signup and view all the answers

What is a common adverse effect associated with the use of ibuprofen?

GI discomfort and bleeding Signup and view all the answers

Which symptom should prompt a nurse to discontinue the administration of a corticosteroid?

Signs of systemic infection Signup and view all the answers

What is the primary therapeutic use of Echinacea in healthcare?

Promotion of wound healing and treatment of colds Signup and view all the answers

What is the main function of T cells in the immune response?

Directly kill infected cells Signup and view all the answers

Which type of vaccine utilizes a lab-made version of a virus to prevent infection?

Recombinant vaccine Signup and view all the answers

Which immunoglobulin primarily functions in allergy responses?

IgE Signup and view all the answers

What effect do immunomodulators like cyclosporine have on the immune system?

Suppress immune response Signup and view all the answers

What is a potential consequence of using steroids in immune therapy?

Suppressed immune function Signup and view all the answers

Which of the following accurately describes a potential consequence of administering Ergotamine to a pregnant patient?

It will cause death to the fetus. Signup and view all the answers

What may occur in Stage 1 of General Anesthesia?

Patient retains consciousness but loses general sensation. Signup and view all the answers

Which of the following statements about local anesthesia is false?

It causes a complete loss of consciousness. Signup and view all the answers

What is a notable interaction when using Lidocaine as a local anesthetic?

Potentially reduced metabolism due to St John's Wort. Signup and view all the answers

What is a common adverse effect of local anesthesia?

Hypotension and respiratory depression. Signup and view all the answers

What is a significant risk associated with the use of morphine?

Severe respiratory depression Signup and view all the answers

Which type of anesthesia allows for loss of consciousness and the elimination of pain sensation during surgical procedures?

General anesthesia Signup and view all the answers

Which medication must be confirmed as contraindicated for use in a pregnant patient due to its potential teratogenic effects?

Ergotamine Signup and view all the answers

What is the main mechanism of Naloxone when administered to treat opioid overdose?

Antagonizes mu and kappa receptors Signup and view all the answers

Which of the following drugs interacts negatively with grapefruit juice, heightening the risk of adverse effects?

St. John's Wort Signup and view all the answers

What is a critical nursing consideration to keep in mind before administering succinylcholine?

Ensure the patient is ventilated before administration Signup and view all the answers

Which of the following immunoglobulins is primarily responsible for providing mucosal immunity?

IgA Signup and view all the answers

What is a primary function of the complement system in the immune response?

Enhance the effectiveness of phagocytosis Signup and view all the answers

Which type of vaccine contains inactivated microbes and may require boosters for ongoing immunity?

Inactivated (killed) vaccines Signup and view all the answers

Which type of leukocyte is primarily involved in allergic reactions and the response to parasitic infections?

Eosinophils Signup and view all the answers

Study Notes

Immune System Overview

Innate immunity is the body's first line of defense against pathogens, offering a non-specific response.
Adaptive immunity involves T and B lymphocytes identifying and responding to specific pathogens by producing targeted antibodies.

Lymphocytes

B cells transform into plasma cells upon encountering an invader, producing antibodies.
T cells, particularly cytotoxic T cells, destroy infected or abnormal cells directly.

Immunomodulators

Cyclosporine is an immunosuppressant used to prevent organ rejection, particularly affecting T cells.
Echinacea and similar supplements may hinder the efficacy of immunosuppressants.
Prednisone reduces inflammation but also suppresses immune function.

Immunoglobulins

IgG: Most abundant, provides long-term immunity, crosses placenta.
IgM: First immunoglobulin produced in response to an infection.
IgE: Involved in allergic reactions.

Vaccines

Live vaccines contain weakened pathogens (e.g., COVID, flu) but may not be safe for immunocompromised individuals.
Inactivated vaccines use killed organisms (e.g., polio vaccine).
Toxoid vaccines (e.g., tetanus) protect against toxins.
Recombinant vaccines are lab-made and cannot cause the disease.

Pain Management and Analgesics

Nociceptors detect pain; A fibers respond to sharp pain, while C fibers handle duller pain.
Morphine targets mu and kappa receptors for severe pain but carries risks such as respiratory depression.
Naloxone (Narcan) is used to reverse opioid overdose effects.

Non-Opioid Analgesics

NSAIDs (e.g., aspirin, ibuprofen) inhibit COX enzymes to reduce pain and inflammation.
Aspirin has significant anticoagulant effects and may cause Reye's syndrome in children.
Ibuprofen is contraindicated in patients with peptic ulcer disease and should be used cautiously in those with kidney conditions.

Anesthesia

Local anesthesia (e.g., lidocaine) focuses on a specific area without loss of consciousness.
General anesthesia has stages, with Stage 3 being surgical anesthesia and Stage 4 being dangerous as it can lead to respiratory failure.
Nitrous oxide is a short-acting anesthetic that does not cause complete unconsciousness.

Adverse Effects of Anesthetics

Succinylcholine induces paralysis without pain relief and is unsafe for those with malignant hyperthermia.
Isoflurane can cause muscle relaxation but is contraindicated in head injuries.

Immunity Classification

Passive immunity involves pre-formed antibodies, such as maternal antibodies crossed through the placenta.
Active immunity develops from exposure to pathogens or vaccinations.
Cytokines produced by macrophages enhance immune responses against infections.

Nursing Considerations

Administrate immunostimulants cautiously in patients with autoimmune disorders.
Monitor for signs of toxicity when using immunosuppressants like cyclosporine, particularly regarding kidney function.
Assess for blood pressure changes and respiratory rate in patients receiving opioids or opioid antagonists.

Additional Drug Considerations

Interactions with grapefruit juice can elevate drug levels significantly, particularly with cyclosporine.
Long-term steroid use may necessitate gradual tapering to avoid adrenal insufficiency and hyperglycemia.
Combination of sedatives and opioids requires careful monitoring due to respiratory depression risks.

Pain Classification

Acute pain occurs suddenly and typically has a clear cause, whereas chronic pain is long-lasting and often more challenging to treat.
PCA (Patient-Controlled Analgesia) allows patients to manage their pain effectively while ensuring safety protocols are followed.

Specific Conditions and Treatments

Migraines may be treated with triptans, which can cause vasoconstriction but are contraindicated in patients with heart conditions or pregnant individuals.
Ergotamine is category X for pregnancy and should not be given to those who may be pregnant.### Corticosteroids
Consult a drug guide prior to administration.
Administer via intramuscular (IM) injection.
Avoid if signs of systemic infection are present.
Must taper off slowly to prevent withdrawal symptoms.

Acetaminophen

Therapeutic Class: Antipyretic and analgesic.
Pharmacologic Class: Centrally acting COX inhibitor.
Function: Reduces fever by acting on the hypothalamus, lacks anti-inflammatory properties and does not affect platelet aggregation.
Adverse Effects: Rare but includes risk for liver damage at high doses.
Contraindications: Chronic alcoholism is a major risk factor.
Interactions: Careful with other hepatotoxic drugs.
Nursing Considerations: Monitor AST/ALT levels, do not exceed 4g/day, avoid in regular alcohol consumers, Pregnancy Category B.
Overdose Treatment: Acetylcysteine is the antidote.

Pain Assessment and Classification

Types: Acute vs. Chronic pain; Chronic pain includes neuropathic pain.
Measurement: Scales and instruments are used for quantification.
Classifications: Somatic pain (localized and sharp) vs. Visceral pain (dull, difficult to diagnose, harder to treat).

Pain Transmission Process

Nociceptors are stimulated, sending impulses via A (myelinated, fast) and C (non-myelinated, slow) fibers to the spinal cord.
Neurotransmitter Substance P is released, transmitting pain signals to the brain.
Chronic pain may lead to psychological issues.

Opioid Analgesics

Classifications: Opioid Agonist, Antagonist, and Mixed Agonist-Antagonist.
Opioid Agonist: Treats severe pain (e.g., morphine, codeine, oxycodone).
Opioid Antagonist: Reverses opioid intoxication severity (e.g., naloxone).
Mixed Agonist-Antagonist: Stimulates opioid receptors with fewer adverse effects (e.g., butorphanol).

Morphine

Therapeutic Class: Opioid analgesic.
Pharmacologic Class: Opioid agonist.
Action/Use: Binds to Mu and Kappa receptors, providing significant pain relief for severe pain.
Adverse Effects: Dysphoria, hallucinations, nausea, constipation, and respiratory depression.
Overdose: Can cause severe respiratory depression or cardiac arrest.
Interactions: CNS depressants may enhance effects.

Codeine, Oxycodone, Hydromorphone

Act primarily on Mu receptors; provide relief for moderate to severe pain.
Adverse effects include respiratory depression, constipation, orthostatic hypotension, sedation, nausea, and vomiting.
Interactions: Caution with CNS depressants, anticholinergics, antihistamines.
Nursing Administration: Monitor pain levels and follow controlled substances procedures.

Naloxone (Narcan)

Therapeutic Class: Drug for acute opioid overdose treatment.
Pharmacologic Class: Opioid receptor antagonist.
Action/Use: Reverses opioid effects in emergencies, induces withdrawal symptoms.
Adverse Effects: Increased blood pressure, tremors, hyperventilation, nausea.

Aspirin

Therapeutic Class: Non-opioid analgesic, NSAID.
Pharmacologic Class: Salicylate.
Action/Use: Inhibits prostaglandin synthesis for pain/inflammation relief; anticoagulation properties.
Adverse Effects: GI discomfort, bleeding, salicylism.
Contraindications: Caution with anticoagulants; Reye syndrome in children.
Nursing Considerations: Discontinue one week prior to surgery, Pregnancy Category D.

Ibuprofen

Therapeutic Class: Non-opioid analgesic, NSAID.
Pharmacologic Class: COX-1 and COX-2 inhibitor.
Action/Use: Reduces inflammation and relieves mild to moderate pain; fever reduction.
Adverse Effects: Risk of impaired kidney function and GI bleeding.

Celecoxib

Therapeutic Class: Non-opioid analgesic, NSAID (2nd generation).
Pharmacologic Class: COX-2 inhibitor.
Adverse Effects: Back pain, heightened blood pressure, increased cardiovascular risks.

Migraines and Treatments

Tension Headache: Most common, treated with OTC analgesics.
Migraine Treatment: Sumatriptan for vasoconstriction of cranial arteries; Ergotamine for unresponsive patients.

Sumatriptan

Therapeutic Class: Antimigraine drug.
Pharmacologic Class: Triptan.
Adverse Effects: Dizziness, drowsiness, chest pressure.

Ergotamine

Therapeutic Class: Antimigraine drug.
Pharmacologic Class: Ergot alkaloid.
Adverse Effects: GI discomfort, risk of ergotism leading to gangrene.

Local Anesthesia

Patient remains conscious; administered via topical or nerve block.
Mechanism: Blocks sodium ion entry into nerves, often combined with epinephrine for vasoconstriction.

Lidocaine

Therapeutic Class: Anesthesia.
Pharmacologic Class: Sodium channel blocker.
Adverse Effects: CNS excitement, convulsions, respiratory depression.

General Anesthesia

Induces complete sensation loss and unconsciousness.
Stages:
- Stage 1: Loss of pain
- Stage 2: Distress symptoms
- Stage 3: Surgical anesthesia
- Stage 4: Medullary paralysis (critical concern).

Propofol

Therapeutic Class: General anesthesia.
Pharmacologic Class: NMDA receptor agonist.
Adverse Effects: Apnea, respiratory depression.

Nitrous Oxide

Therapeutic Class: General anesthesia.
Aimed for short procedures; low potency.

Adjuncts to Anesthesia

Anticholinergics pre-surgery for secretions; opioids might be administered intraoperatively.

Succinylcholine

Therapeutic Class: Skeletal muscle paralytic drug.
Pharmacologic Class: Depolarizing blocker.
Adverse Effects: Bradycardia, respiratory depression, malignant hyperthermia risk.

Cyclobenzaprine

Therapeutic Class: Centrally acting skeletal muscle relaxant.
Adverse Effects: Drowsiness, blurred vision, dizziness.

Dantrolene Sodium

Therapeutic Class: Direct-acting antispasmodic.
Main Uses: Cerebral palsy, spinal injuries, malignant hyperthermia treatment.
Adverse Effects: CNS depressant effects, muscle weakness.

Immune System Overview

Innate immunity is the body's first line of defense against pathogens, offering a non-specific response.
Adaptive immunity involves T and B lymphocytes identifying and responding to specific pathogens by producing targeted antibodies.

Lymphocytes

B cells transform into plasma cells upon encountering an invader, producing antibodies.
T cells, particularly cytotoxic T cells, destroy infected or abnormal cells directly.

Immunomodulators

Cyclosporine is an immunosuppressant used to prevent organ rejection, particularly affecting T cells.
Echinacea and similar supplements may hinder the efficacy of immunosuppressants.
Prednisone reduces inflammation but also suppresses immune function.

Immunoglobulins

IgG: Most abundant, provides long-term immunity, crosses placenta.
IgM: First immunoglobulin produced in response to an infection.
IgE: Involved in allergic reactions.

Vaccines

Live vaccines contain weakened pathogens (e.g., COVID, flu) but may not be safe for immunocompromised individuals.
Inactivated vaccines use killed organisms (e.g., polio vaccine).
Toxoid vaccines (e.g., tetanus) protect against toxins.
Recombinant vaccines are lab-made and cannot cause the disease.

Pain Management and Analgesics

Nociceptors detect pain; A fibers respond to sharp pain, while C fibers handle duller pain.
Morphine targets mu and kappa receptors for severe pain but carries risks such as respiratory depression.
Naloxone (Narcan) is used to reverse opioid overdose effects.

Non-Opioid Analgesics

NSAIDs (e.g., aspirin, ibuprofen) inhibit COX enzymes to reduce pain and inflammation.
Aspirin has significant anticoagulant effects and may cause Reye's syndrome in children.
Ibuprofen is contraindicated in patients with peptic ulcer disease and should be used cautiously in those with kidney conditions.

Anesthesia

Local anesthesia (e.g., lidocaine) focuses on a specific area without loss of consciousness.
General anesthesia has stages, with Stage 3 being surgical anesthesia and Stage 4 being dangerous as it can lead to respiratory failure.
Nitrous oxide is a short-acting anesthetic that does not cause complete unconsciousness.

Adverse Effects of Anesthetics

Succinylcholine induces paralysis without pain relief and is unsafe for those with malignant hyperthermia.
Isoflurane can cause muscle relaxation but is contraindicated in head injuries.

Immunity Classification

Passive immunity involves pre-formed antibodies, such as maternal antibodies crossed through the placenta.
Active immunity develops from exposure to pathogens or vaccinations.
Cytokines produced by macrophages enhance immune responses against infections.

Nursing Considerations

Administrate immunostimulants cautiously in patients with autoimmune disorders.
Monitor for signs of toxicity when using immunosuppressants like cyclosporine, particularly regarding kidney function.
Assess for blood pressure changes and respiratory rate in patients receiving opioids or opioid antagonists.

Additional Drug Considerations

Interactions with grapefruit juice can elevate drug levels significantly, particularly with cyclosporine.
Long-term steroid use may necessitate gradual tapering to avoid adrenal insufficiency and hyperglycemia.
Combination of sedatives and opioids requires careful monitoring due to respiratory depression risks.

Pain Classification

Acute pain occurs suddenly and typically has a clear cause, whereas chronic pain is long-lasting and often more challenging to treat.
PCA (Patient-Controlled Analgesia) allows patients to manage their pain effectively while ensuring safety protocols are followed.

Specific Conditions and Treatments

Migraines may be treated with triptans, which can cause vasoconstriction but are contraindicated in patients with heart conditions or pregnant individuals.
Ergotamine is category X for pregnancy and should not be given to those who may be pregnant.### Corticosteroids
Consult a drug guide before administration.
Administer intramuscularly; avoid if signs of a systemic infection are present.
Taper dosage slowly to prevent withdrawal symptoms.

Acetaminophen

Therapeutic Classification: Antipyretic and analgesic.
Pharmacological Classification: Centrally acting COX inhibitor.
Actions/Uses: Reduces fever by acting on the hypothalamus, lacks anti-inflammatory properties, and does not affect platelet aggregation.
Adverse Effects: Rare at therapeutic doses but carry a risk for liver damage.
Contraindications: Chronic alcoholism.
Interactions: Use caution with other hepatotoxic drugs.
Nursing Considerations: Monitor AST/ALT levels; do not exceed 4g/day; avoid in regular alcohol consumers; categorized as pregnancy category B.
Overdose treatment: Acetylcysteine.

Pain Classification

Differentiates between acute and chronic pain.
Chronic pain often features neuropathic characteristics.
Pain can be measured using scales and classified by source: somatic vs. visceral.

Somatic vs. Visceral Pain

Somatic Pain: Localized, sharp, and well-defined.
Visceral Pain: Dull, difficult to locate, challenging to diagnose and treat.
Neuropathic Pain: Complex and very difficult to manage.

Pain Transmission Process

Nociceptors are stimulated, sending impulses via myelinated A fibers (quick response) and unmyelinated C fibers (slower).
Release of Substance P leads to continued pain impulse transmission to the brain.
Chronic pain may result in psychological impacts.

Opioid Analgesics

Used for severe pain; operate at various receptor sites (Mu, Kappa, Delta).
Opioid Agonists: Treat severe to extreme pain; examples include morphine, codeine, oxycodone, hydromorphone.
Opioid Antagonists: Reverse opioid intoxication effects; naloxone (Narcan) is crucial for emergencies.

Morphine

Therapeutic Classification: Opioid analgesic.
Pharmacological Classification: Opioid agonist.
Actions/Uses: Binds to Mu and Kappa receptors for profound analgesia; used for both acute and chronic pain.
Adverse Effects: Dysphoria, hallucinations, nausea, constipation, dizziness, itching; overdose risks include respiratory depression/cardiac arrest.
Nursing Considerations: Monitor for orthostatic hypotension; classified as a Schedule II drug.

Other Opioid Agonists

Codeine, Oxycodone, Hydromorphone: Act on Mu receptors for moderate to severe pain relief and cough suppression.
Common adverse effects: Respiratory depression, constipation, sedation, and urinary retention.

Naloxone (Narcan)

Therapeutic Classification: Drug for acute opioid overdose.
Pharmacological Classification: Opioid receptor antagonist.
Actions/Uses: Reverses opioid effects in emergencies but can induce withdrawal symptoms.
Adverse Effects: Increased blood pressure, tremors, nausea, drowsiness.

Non-Opioid Analgesics and NSAIDs

Aspirin: Salicylate, provides mild relief of fever and has anticoagulant activity, but can cause GI discomfort and Reye's syndrome.
Ibuprofen: COX-1 and COX-2 inhibitor, effective for inflammation and mild to moderate pain; monitor for GI bleeding.
Celecoxib: Second-generation NSAID, COX-2 inhibitor; monitor for cardiovascular risks and kidney function.

Migraines and Treatments

Tension Headaches: Managed with OTC analgesics.
Migraines: Treat with meds like Sumatriptan, which causes vasoconstriction of cranial arteries.
Ergotamine: Used for migraine prevention but has a risk of complications like gangrene from vascular constriction.

Local Anesthesia

Localized pain relief methods include topical applications and nerve blocks. Sodium channel blockers like Lidocaine are commonly used.
Adverse effects for Lidocaine: CNS excitement, respiratory depression, hypotension.

General Anesthesia

Propofol: NMDA receptor agonist for induction and maintenance; watch for respiratory depression and hypotension.
Nitrous Oxide: Inhalation gas effective for short procedures, resulting in mild sedation without full consciousness loss.
Isoflurane: Inhaled anesthetic with muscle relaxant properties; watch for malignant hyperthermia.

Muscle Relaxants

Succinylcholine: Depolarizing blocker used with general anesthesia; contraindicated in patients with a history of malignant hyperthermia.
Cyclobenzaprine: Centrally acting relaxant; monitor for common CNS side effects and potential cardiovascular risks.
Dantrolene Sodium: Direct-acting muscle relaxant; used for spastic conditions and malignant hyperthermia treatment.

Overall Considerations

Good postoperative pain control can enhance recovery and discharge times.
Monitor vital signs and have emergency protocols in place for anesthesia and opioid-related interventions.

Immune System Overview

Innate immunity is the body's first line of defense against pathogens, offering a non-specific response.
Adaptive immunity involves T and B lymphocytes identifying and responding to specific pathogens by producing targeted antibodies.

Lymphocytes

B cells transform into plasma cells upon encountering an invader, producing antibodies.
T cells, particularly cytotoxic T cells, destroy infected or abnormal cells directly.

Immunomodulators

Cyclosporine is an immunosuppressant used to prevent organ rejection, particularly affecting T cells.
Echinacea and similar supplements may hinder the efficacy of immunosuppressants.
Prednisone reduces inflammation but also suppresses immune function.

Immunoglobulins

IgG: Most abundant, provides long-term immunity, crosses placenta.
IgM: First immunoglobulin produced in response to an infection.
IgE: Involved in allergic reactions.

Vaccines

Live vaccines contain weakened pathogens (e.g., COVID, flu) but may not be safe for immunocompromised individuals.
Inactivated vaccines use killed organisms (e.g., polio vaccine).
Toxoid vaccines (e.g., tetanus) protect against toxins.
Recombinant vaccines are lab-made and cannot cause the disease.

Pain Management and Analgesics

Nociceptors detect pain; A fibers respond to sharp pain, while C fibers handle duller pain.
Morphine targets mu and kappa receptors for severe pain but carries risks such as respiratory depression.
Naloxone (Narcan) is used to reverse opioid overdose effects.

Non-Opioid Analgesics

NSAIDs (e.g., aspirin, ibuprofen) inhibit COX enzymes to reduce pain and inflammation.
Aspirin has significant anticoagulant effects and may cause Reye's syndrome in children.
Ibuprofen is contraindicated in patients with peptic ulcer disease and should be used cautiously in those with kidney conditions.

Anesthesia

Local anesthesia (e.g., lidocaine) focuses on a specific area without loss of consciousness.
General anesthesia has stages, with Stage 3 being surgical anesthesia and Stage 4 being dangerous as it can lead to respiratory failure.
Nitrous oxide is a short-acting anesthetic that does not cause complete unconsciousness.

Adverse Effects of Anesthetics

Succinylcholine induces paralysis without pain relief and is unsafe for those with malignant hyperthermia.
Isoflurane can cause muscle relaxation but is contraindicated in head injuries.

Immunity Classification

Passive immunity involves pre-formed antibodies, such as maternal antibodies crossed through the placenta.
Active immunity develops from exposure to pathogens or vaccinations.
Cytokines produced by macrophages enhance immune responses against infections.

Nursing Considerations

Administrate immunostimulants cautiously in patients with autoimmune disorders.
Monitor for signs of toxicity when using immunosuppressants like cyclosporine, particularly regarding kidney function.
Assess for blood pressure changes and respiratory rate in patients receiving opioids or opioid antagonists.

Additional Drug Considerations

Interactions with grapefruit juice can elevate drug levels significantly, particularly with cyclosporine.
Long-term steroid use may necessitate gradual tapering to avoid adrenal insufficiency and hyperglycemia.
Combination of sedatives and opioids requires careful monitoring due to respiratory depression risks.

Pain Classification

Acute pain occurs suddenly and typically has a clear cause, whereas chronic pain is long-lasting and often more challenging to treat.
PCA (Patient-Controlled Analgesia) allows patients to manage their pain effectively while ensuring safety protocols are followed.

Specific Conditions and Treatments

Migraines may be treated with triptans, which can cause vasoconstriction but are contraindicated in patients with heart conditions or pregnant individuals.
Ergotamine is category X for pregnancy and should not be given to those who may be pregnant.### Corticosteroids
Consult a drug guide before administration.
Administer intramuscularly; avoid if signs of a systemic infection are present.
Taper dosage slowly to prevent withdrawal symptoms.

Acetaminophen

Therapeutic Classification: Antipyretic and analgesic.
Pharmacological Classification: Centrally acting COX inhibitor.
Actions/Uses: Reduces fever by acting on the hypothalamus, lacks anti-inflammatory properties, and does not affect platelet aggregation.
Adverse Effects: Rare at therapeutic doses but carry a risk for liver damage.
Contraindications: Chronic alcoholism.
Interactions: Use caution with other hepatotoxic drugs.
Nursing Considerations: Monitor AST/ALT levels; do not exceed 4g/day; avoid in regular alcohol consumers; categorized as pregnancy category B.
Overdose treatment: Acetylcysteine.

Pain Classification

Differentiates between acute and chronic pain.
Chronic pain often features neuropathic characteristics.
Pain can be measured using scales and classified by source: somatic vs. visceral.

Somatic vs. Visceral Pain

Somatic Pain: Localized, sharp, and well-defined.
Visceral Pain: Dull, difficult to locate, challenging to diagnose and treat.
Neuropathic Pain: Complex and very difficult to manage.

Pain Transmission Process

Nociceptors are stimulated, sending impulses via myelinated A fibers (quick response) and unmyelinated C fibers (slower).
Release of Substance P leads to continued pain impulse transmission to the brain.
Chronic pain may result in psychological impacts.

Opioid Analgesics

Used for severe pain; operate at various receptor sites (Mu, Kappa, Delta).
Opioid Agonists: Treat severe to extreme pain; examples include morphine, codeine, oxycodone, hydromorphone.
Opioid Antagonists: Reverse opioid intoxication effects; naloxone (Narcan) is crucial for emergencies.

Morphine

Therapeutic Classification: Opioid analgesic.
Pharmacological Classification: Opioid agonist.
Actions/Uses: Binds to Mu and Kappa receptors for profound analgesia; used for both acute and chronic pain.
Adverse Effects: Dysphoria, hallucinations, nausea, constipation, dizziness, itching; overdose risks include respiratory depression/cardiac arrest.
Nursing Considerations: Monitor for orthostatic hypotension; classified as a Schedule II drug.

Other Opioid Agonists

Codeine, Oxycodone, Hydromorphone: Act on Mu receptors for moderate to severe pain relief and cough suppression.
Common adverse effects: Respiratory depression, constipation, sedation, and urinary retention.

Naloxone (Narcan)

Therapeutic Classification: Drug for acute opioid overdose.
Pharmacological Classification: Opioid receptor antagonist.
Actions/Uses: Reverses opioid effects in emergencies but can induce withdrawal symptoms.
Adverse Effects: Increased blood pressure, tremors, nausea, drowsiness.

Non-Opioid Analgesics and NSAIDs

Aspirin: Salicylate, provides mild relief of fever and has anticoagulant activity, but can cause GI discomfort and Reye's syndrome.
Ibuprofen: COX-1 and COX-2 inhibitor, effective for inflammation and mild to moderate pain; monitor for GI bleeding.
Celecoxib: Second-generation NSAID, COX-2 inhibitor; monitor for cardiovascular risks and kidney function.

Migraines and Treatments

Tension Headaches: Managed with OTC analgesics.
Migraines: Treat with meds like Sumatriptan, which causes vasoconstriction of cranial arteries.
Ergotamine: Used for migraine prevention but has a risk of complications like gangrene from vascular constriction.

Local Anesthesia

Localized pain relief methods include topical applications and nerve blocks. Sodium channel blockers like Lidocaine are commonly used.
Adverse effects for Lidocaine: CNS excitement, respiratory depression, hypotension.

General Anesthesia

Propofol: NMDA receptor agonist for induction and maintenance; watch for respiratory depression and hypotension.
Nitrous Oxide: Inhalation gas effective for short procedures, resulting in mild sedation without full consciousness loss.
Isoflurane: Inhaled anesthetic with muscle relaxant properties; watch for malignant hyperthermia.

Muscle Relaxants

Succinylcholine: Depolarizing blocker used with general anesthesia; contraindicated in patients with a history of malignant hyperthermia.
Cyclobenzaprine: Centrally acting relaxant; monitor for common CNS side effects and potential cardiovascular risks.
Dantrolene Sodium: Direct-acting muscle relaxant; used for spastic conditions and malignant hyperthermia treatment.

Overall Considerations

Good postoperative pain control can enhance recovery and discharge times.
Monitor vital signs and have emergency protocols in place for anesthesia and opioid-related interventions.

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This quiz covers key concepts in immunology, focusing on innate and adaptive immunity. You'll explore the roles of T and B lymphocytes, the function of antibodies, and the use of immunomodulators in organ transplants. Test your knowledge on how the body differentiates between pathogens and immune responses.