MODULE 3: DRUGS ACTING ON THE IMMUNE plasmin to dissolve clots, and activates the kinin system

SYSTEM responsible for activation of the inflammatory response

• Interferon
I. Introduction to Immune Response and
tissue hormone that is released in response to viral
Inflammation
invasion; blocks viral replication
II. Anti-Inflammatory, Antiarthritis and Related
• Interleukins
Agents
chemicals released by white blood cells (WBCs) to
III. Immune Modulators
communicate with other WBCs and to support the
IV. Vaccines and Sera
inflammatory and immune reactions
• Kinin system
I. Introduction to Immune Response and system activated by Hageman factor as part of the
Inflammation inflammatory response; includes bradykinin
• Leukocytes
Key Terms white blood cells; can be neutrophils, basophils, or
• Antibodies eosinophils
immunoglobulins; produced by B cell plasma cells in • Lymphocytes
response to a specific protein; react with that protein to white blood cells with large, varied nuclei; can be T cells
cause its destruction directly or through activation of or B cells
the inflammatory response • Macrophages
• Antigen mature leukocytes that are capable of phagocytizingan
foreign protein antigen (foreign protein); also called monocytes or
• Arachidonic acid mononuclear phagocytes
released from injured cells to stimulate the • Major histocompatibility complex
inflammatory response through activation of various the genetic identification code carried on a
chemical substances chromosome; produces several proteins or antigens
• Autoimmune disease that allow the body to recognize cells as being self-cells
a disorder that occurs when the body responds to • Mast cells
specific self-antigens to produce antibodies or cell- fixed basophils found in the respiratory and
mediated responses against its own cells gastrointestinal tracts and in the skin, which release
• B cells chemical mediators of the inflammatory and immune
lymphocytes programmed to recognize specific responses when they are stimulated by local irritation
proteins; when activated, these cells cause the • Myelocytes
production of antibodies to react with that protein leukocyte-producing cells in the bone marrow that can
• Calor develop into neutrophils, basophils, eosinophils,
heat, one of the four cardinal signs of inflammation; monocytes, or macrophages
caused by activation of the inflammatory response • Phagocytes
• Chemotaxis neutrophils that are able to engulf and digest foreign
property of drawing neutrophils to an area material
• Complement proteins • Phagocytosis
series of cascading proteins that react with the antigen– the process of engulfing and digesting foreign pyrogens
antibody complex to destroy the protein or stimulate an • Pyrogen
inflammatory reaction fever-causing substance
• Dolor • Rubor
pain, one of the four cardinal signs of inflammation; redness, one of the four cardinal signs of inflammation;
caused by activation of the inflammatory response caused by activation of the inflammatory response
• Hageman factor • T cells
first factor activated when a blood vessel or cell is lymphocytes programmed in the thymus gland to
injured; starts the cascading reaction of the clotting recognize self-cells; may be effector T cells, helper T
factors, activates the conversion of plasminogen to cells, or suppressor T cells
 • Tumor
swelling, one of the four cardinal signs of inflammation;
caused by activation of the inflammatory response
Body defenses
Types:
1. Barrier Defenses
2. Cellular Defenses
1.Barrier defenses
• anatomical barriers exist to prevent the
entry of foreign pathogens and to serve as
important lines of defense in protecting the
body.
Types:
A. Skin and mucous membranes
B. Gastric acid
C. Major histocompatibility complex (MHC)
D. Normal Flora
a. Skin and mucous membranes
• Skin
- first line of defense, a physical barrier to
protect the internal tissues and organs
- Glands in the skin secrete chemicals that
destroy or repel many pathogens.
- top layer falls off daily, which makes it
difficult for any pathogen to colonize on the
skin.
- normal bacterial flora of the skin help to
destroy many disease-causing pathogens.
• Mucous Membranes
- line the areas of the body that are exposed
to external influences but do not have the
benefit of skin protection.
Example:
• respiratory tract, lined with cilia which
sweep any captured pathogens or foreign
materials upward toward the mouth and
swallowed, coughed or sneezed.
• gastrointestinal (GI) tract, protective
coating, preventing erosion of GI cells by
the acidic environment of the stomach and
secretes mucus that serves as a lubricant
throughout the GI tract to facilitate
movement of the food bolus and of waste
products and acts as a thick barrier to
prevent foreign pathogens from penetrating
the GI tract and entering the body.
genitourinary (GU) tract, provides direct protection
against injury and trauma and traps any pathogens
in the area for destruction by the body
b. Gastric Acid
• The acidity of the stomach destroys many
would-be pathogens that are either
ingested or swallowed after removal from
the respiratory tract.
c. Major Histocompatibility complex
d. ability to distinguish between self-cells and
foreign cells.
e. The genetic identification code carried on a
chromosome in humans.
f. produces several proteins called
histocompatibility antigens, or human
leukocyte antigens (HLAs)
Antigens
located on the cell membrane and allow the body
to recognize cells as being self-cells
E. Normal flora
- are the microorganisms that live on
another living organism (human or
animal) or inanimate object without
causing disease.
- prevent colonization by pathogens by
competing for attachment sites or
for essential nutrients. 
3. Cellular defenses
Includes:
• Lymphocytes (T and B cells)
• Myelocytes (neutrophils, eosinophils,
basophils, and macrophages).
Types:
A. Mononuclear Phagocyte System (MPS)
B. Inflammatory Response
C. Immune Response
 a. Mononuclear phagocyte system Neutrophils
• Previously called the reticuloendothelial - are polymorphonuclear leukocytes that are
system capable of moving outside of the blood
Types: stream (diapedesis) and engulfing and
I. Leukocytes digesting foreign material (phagocytosis)
II. Lymphoid tissues - are rapidly produced and move to the site
III. chemical mediators. of the insult to attack the foreign substance
when the body is injured or invaded by a
I. Leukochytes (white Blood Cells) pathogen
Produced by the stem cells in the bone marrow MYELOCYTIC CELLS
• Basophils
2 Types:
a. Lymphocytes
- are myelocytic leukocytes that are not
- the key components of the immune capable of phagocytosis.
system and consist of T cells, B cells, and - contain chemical substances or mediators
natural killer cells that are important for initiating and
b. Myelocytes maintaining an immune or inflammatory
- develop into a number of different cell response.
types that are important in both the basic - release many of the chemical mediators of
inflammatory response and the immune the inflammatory and immune responses
response
when they are stimulated by local irritation.
• include neutrophils, basophils,
eosinophils, and monocytes/macrophages Example:
• Histamine
• Heparin
• other chemicals used in the inflammatory
response

• Eusinophils
- are circulating myelocytic leukocytes whose
exact function is not understood.
- often found at the site of allergic reactions
and may be responsible for removing the
proteins and active components of the
immune reaction from the site of an allergic
TYPES OF WHITE BLOOD CELLS, OR response
LEUKOCYTES,PRODUCED BY THE BODY. - contain chemical substances or mediators
that are important for initiating and
MYELOCYTIC CELLS maintaining an immune or inflammatory
Types: response.
• Neutrophils
• Basophils • Monocytes/Macrophages
• Eusinophils - also called macrophages.
• Monocytes/Macrophages - are mature leukocytes capable of
phagocytizing an antigen.
- remove foreign material from the body,
including pathogens, debris from dead cells,
 and necrotic tissue from injury sites and
can process antigens and present them to
active lymphocytes for destruction
- can circulate in the blood stream or they
can be fixed in specific tissues
- respond to chemical mediators released by
other cells that are active in the
inflammatory and immune responses to
increase the intensity of a response and to
facilitate the body’s reaction.
Ii. LYMPHOID TISSUE
• play an important part in the cellular
defense system
Types:
• lymph nodes
• Spleen
• Thymus gland
• Bone marrow
• Lymphoid tissue
b. Inflammatory response
• is the local reaction of the body to invasion
or injury.
• sets off a series of events and chemical
reactions for any insult to the body that
injures cells or tissues
Types Response:
A. Factor XII or Hageman Factor Activation
B. Histamine Release
C. Chemotaxis
a. Hageman factor activation (factor xii)
Kinin system
• Bradykinin and other kinins are converted
from the precursor substance kininogen
caused by the activation of kallikrein from
the local tissue by the Hageman factor.
Bradykinin:
• first kinin identified and the one that is best
understood.
• causes local vasodilation, which brings more
blood to the injured area and allows white
blood cells to escape into the tissues.
• causes the release of arachidonic acid from
the cell membrane which causes the release
of other substances called autacoids.
Kinin system cont…
Autocoids
• act like local hormones—they are
released from cells, cause an effect in the
immediate area, and then are broken
down.
Types
• Prostaglandins, augment the
inflammatory reaction and some of which
block it.
• Leukotrienes, cause vasodilation and
increased capillary permeability, and
some of which can block the reactions.
• Thromboxanes, cause local
vasoconstriction and facilitate platelet
aggregation and blood
coagulation(clotting).
b . Histamine release
• caused by an injury to a cell membrane.
• causes vasodilation
• alters capillary permeability, making it
easier for neutrophils and blood chemicals
to leave the bloodstream and enter the
injured area.
• stimulates pain perception.
c. Chemotaxis
• the ability to attract neutrophils and to
stimulate them and other macrophages in
the area to be very aggressive.
• activation of the neutrophils and release
of other chemicals into
• the area can lead to cell injury and
destruction.
• can cause local cellular breakdown and
further inflammation, which can develop
into a vicious cycle leading to cell death.
Cardinal Signs of Inflammation
• Pain (Dolor)
• Redness (Rubor)
• Swelling (Tumor)
• Heat (Calor)
The inflammatory response in relation to the four
cardinal signs of inflammation.
c.immune response
Types of Immune Response:
a. Humoral immune response
b. Cell-mediated immune response
Types of Immunity
a. Innate/Natural Immunity
b. Adaptive/Active Immunity
c. Passive Immunity
Humoral immune response
Cell-mediated immune response
T Cells
- migrate from the bone marrow to the
thymus gland for activation and maturation
• are programmed in the thymus gland and
provide what is called cell-mediated
immunity
3 Types of Cells:
a. Effector or cytotoxic T cells
b. Helper T cells
c. Suppressor T cells
a. Effector or Cytotoxic T cells
- are found throughout the body
• are aggressive against non– self-cells,
releasing cytokines, or chemicals, that can
either directly destroy a foreign cell or mark
it for aggressive destruction by phagocytes
in the area via an inflammatory response.
b. Helper T cells
- respond to the chemical indicators of
immune activity and stimulate other
lymphocytes, including B cells, to be more
aggressive and responsive.
c.Suppressor T cells
- respond to rising levels of chemicals
associated with an immune response to
suppress or slow the reaction
B Cells
- are programmed to identify specific
proteins, or antigens.
- provide humoral immunity
- reacts with its specific antigen and changes
to become a plasma cell.
Plasma Cells
• produce antibodies, or immunoglobulins,
which circulate in the body and react with
this specific antigen when it is encountered.
• When the antigen and antibody react, they
form an antigen–antibody complex.
Complimentary Proteins
- react in a cascade fashion to form a ring
around the antigen–antibody complex
- can destroy the antigen by altering the
membrane, allowing an osmotic inflow of
fluid that causes the cell to burst
• induce chemotaxis (attraction of phagocytic
cells to the area), increase the activity of
phagocytes, and release histamine
Antibody Formation
- The initial formation of antibodies, or
primary response, takes several days.
• Once activated, the B cells form memory
cells that will produce antibodies for
immediate release in the future if the
antigen is encountered.
• antibodies are released in the form of
immunoglobulins
Types of Immunoglobulins:
• Immunoglobulin M (IgM)
• Immunoglobulin G (IgG)
• Immunoglobulin A (IgA)
• Immunoglobulin E (IgE)
• Immunoglobulin D (IgD)
Immunoglobulin M (IgM)
- contains the antibodies produced at the
first exposure to the antigen or fighting new
infections
Immunoglobulin G (IgG)
- contains antibodies made by the memory
cells that circulate and enter the tissue;
mostly found in the serum is IgG.
- protects against bacterial and viral
infections.
- IgG can take time to form after an infection
or immunization.
Immunoglobulin A (IgA)
- found in tears, saliva, sweat, mucus, and
bile. It is secreted by plasma cells in the GI
and respiratory tracts and in epithelial cells.
- react with specific pathogens that are
encountered in exposed areas of the body
Immunoglobulin E (IgE)
- related to allergic responses and to the
activation of mast cells
- Normally found in small amounts in the
blood
- higher amounts when the body overreacts
to allergens or is fighting an infection from a
parasite.
Immunoglobulin D (IgD)
is another identified immunoglobulin whose role
has not been determined.
Other mediators
Interferons
• are chemicals that are secreted by cells that
have been invaded by viruses and possibly
by other stimuli
• prevent viral replication and also suppress
malignant cell replication and tumor
growth.
Interleukins
• chemicals secreted by active leukocytes to
influence other leukocytes.
• Interleukin 1 (IL-1) stimulates T and B cells
to initiate an immune response.
• IL-2 is released from active T cells to
stimulate the production of more T cells
and to increase the activity of B cells,
cytotoxic cells, and natural killer cells.
Key points
• The response to the inflammatory stimuli
involves local vasodilation, increased
capillary permeability, and the stimulation
of pain fibers. These reactions alert the
person to the injury and bring an increased
blood flow to the area.
• The immune response provides a specific
reaction to foreign cells or proteins.
• T cells can be cytotoxic, destroying non–
self-cells; helper, augmenting an immune
reaction; or suppressor, dampening the
immune response to save energy
• B cells produce antibodies in response to
exposure to specific antigens or proteins.
Antibodies react with this antigen to
produce an antigen–antibody complex that
activates complement and will result in
destruction of the antigen.
• Other mediators that affect the immune
and inflammatory responses include
interferons, tissue necrosis factor, and
interleukins.
• The immune and inflammatory responses
work together to protect the body from
injury or foreign pathogens.
Interrelationship of the Immune and
Inflammatory Responses
• The immune and inflammatory responses
work together to protect the body and to
maintain a level of homeostasis within the
body.
• Helper T cells stimulate the activity of B
cells and effector T cells.
• Suppressor T cells monitor the chemical
activity in the body and act to suppress B-
cell and T-cell activity when the foreign
antigen is under control.
• Both B cells and T cells ultimately depend
on an effective inflammatory reaction to
achieve the end goal of destruction of the
foreign protein or cell
Pathophysiology involving the immune system
CONDITIONS THAT CAUSE PROBLEMS INVOLVING
THE IMMUNE SYSTEM:
1. Neoplasm
2. Viral Invasion
3. Autoimmune Disease
4. Transplant Rejection
1. NEOPLASM
• occur when mutant cells escape the normal
surveillance of the immune system and
begin to grow and multiply.
2. VIRAL INVASION
• alters the cell membrane and the antigenic
presentation of the cell which can activate
cellular immunity, or it can be so subtle that
the immune system’s response to the cell is
mild or absent.
3. AUTOIMMUNE DISEASE
• occurs when the body responds to specific
self-antigens to produce antibodies or cell-
mediated immune responses against its
own cells.
4. TRANSPLANT REJECTION
• Organ transplants produce an immune
reaction.
SUMMARY
• The body has several defense mechanisms
in place to protect it from injury or foreign
invasion: the skin, mucous membranes,
normal flora, gastric acid, and the
inflammatory and immune responses.
• The inflammatory response is a general
response to any cell injury and involves
activation of Hageman factor to stimulate
the kinin system and release of histamine
from injured cells to generate local
inflamatory responses.
• The clinical presentation of an inflammatory
reaction is heat (calor), redness (rubor),
swelling (tumor), and pain (dolor).
• The inflammatory response is a nonspecific
reaction to any cellular injury and involves
the activation of various chemicals and
neutrophil activity. The immune response is
specific to an antigen or protein that has
entered the body and involves B cells,
antibodies, and T cells.
• Several types of T cells exist: effector or
cytotoxic T cells, helper T cells, and
suppressor T cells. Effector or cytotoxic T
cells immediately destroy foreign cells.
Helper T cells stimulate the immune and
inflammatory reactions. Suppressor T cells
dampen the immune and inflammatory
responses to conserve energy and prevent
cellular damage.
• B cells are programmed to recognize
specific proteins or foreign antigens. Once
in contact with that protein, the B cell
produces antibodies (immunoglobulins)
that react directly with the protein.
• Reaction of an antibody with the specific
receptor site on the protein activates the
complement cascade of proteins and lyses
the associated protein or precipitates an
aggressive inflammatory reaction around it.
• Other chemicals are involved in
communication among parts of the immune
system and in local response to invasion.
• Any of these chemicals has the potential to
alter the immune response
• The T cells, B cells, and inflammatory
reaction work together to protect the body
from invasion, limit the response to that
invasion, and return the body to a state of
homeostasis.
• Patient problems that occur within the
immune system include the development of
neoplasms, viral invasions of cells that
trigger immune responses, autoimmune
diseases, and rejections of transplanted
organs.
II. Anti-inflammatory, antiarthritis, and
related agents
Key Terms
• Analgesic
compounds with pain-blocking properties, capable
of producing analgesia
• Anti-inflammatory agents
drugs that block the effects of the inflammatory
response
• Antipyretic
blocking fever, often by direct effects on the
thermoregulatory center in the hypothalamus or by
blockade of prostaglandin mediators
• Chrysotherapy
treatment with gold salts; gold is taken up by
macrophages, which then inhibit phagocytosis; it is
reserved for use in patients who are unresponsive
to conventional therapy, and can be very toxic
• Inflammatory response
the body’s nonspecific response to cell injury,
resulting in pain, swelling, heat, and redness in the
affected area
• Nonsteroidal anti-inflammatory drugs
(NSAIDs)
drugs that block prostaglandin synthesis and act as
anti-inflammatory, antipyretic, and analgesic
agents
• Salicylates
salicylic acid compounds, used as anti-
inflammatory, antipyretic, and analgesic agents;
they block the prostaglandin system
• Salicylism
syndrome associated with high levels of salicylates
Signs and Symptoms
dizziness, ringing in the ears, difficulty hearing,
nausea, vomiting, diarrhea, mental confusion, and
lassitude
DRUG LIST
ANTI-INFLAMMATORY, ANTIARTHRITIS, AND
RELATED AGENTS
• inflammatory response is designed to
protect the body from injury and
pathogens.
Take note of this:
• many anti-inflammatory drugs are
available over the counter (OTC), there is a
potential for abuse and overdosing.
• patients may take these drugs and block
the signs and symptoms of a present
illness, thus potentially causing the
misdiagnosis of a problem.
SUMMARY
• The inflammatory response, which is
important for protecting the body from
injury and invasion, produces many of the
signs and symptoms associated with
disease, including fever, aches and pains,
and lethargy.
• Chronic or excessive activity by the
inflammatory response can lead to the
release of lysosomal enzymes and tissue
destruction.
• Anti-inflammatory drugs block various
chemicals associated with the inflammatory
reaction. Anti-inflammatory drugs also may
have antipyretic (feverblocking) and
analgesic (pain-blocking) activities
• Salicylates block prostaglandin activity.
NSAIDs block prostaglandin synthesis.
Acetaminophen causes vasodilation and
heat release, lowering fever and working to
relieve pain. Gold salts prevent macrophage
phagocytosis, lysosomal release, and tissue
damage. DMARDs alter the course of the
inflammatory process and treats arthritis by
aggressively affecting the process of
inflammation.
• Salicylates can cause acidosis and eighth
cranial nerve damage. NSAIDs are most
associated with GI irritation and bleeding.
Acetaminophen can cause serious liver
toxicity. The gold salts cause many systemic
inflammatory reactions. Other antiarthritis
drugs are associated with local injection-site
irritation and increased susceptibility to
infection; leflunomide is associated with
severe hepatic toxicity.
• Many anti-inflammatory drugs are available
OTC, and care must be taken to prevent
abuse or overuse of these drugs.
iII. IMMUNE MODULATORS
Key Terms
• Immune stimulant
drug used to energize the immune system when it is
exhausted from fighting prolonged invasion or needs
help fighting a specific pathogen or cancer cell
• Immune suppressant
drug used to block or suppress the actions of the T cells
and antibody production; used to prevent transplant
rejection and to treat autoimmune diseases
 • Monoclonal antibodies
specific antibodies produced by a single clone of B cells
to react with a very specific antigen
• Recombinant DNA technology
use of bacteria to produce chemicals normally produced
by human cells
DRUG LIST
IMMUNE MODULATORS
• are used to modify the actions of the immune
system
TYPES:
1. Immune stimulants
2. Immune suppressants
1. Immune stimulants
• are used to energize the immune system when
it is exhausted from fighting prolonged invasion
or when the immune system needs help fighting
a specific pathogen or cancer cell.
2. Immune suppressants
• are used to block the normal effects of the
immune system in cases of organ
transplantation (in which non–self-cells are
transplanted into the body and destroyed by
the immune reaction) and in autoimmune
disorders (in which the body’s defenses
recognize self-cells as foreign and work to
destroy them) in some cancers.
SUMMARY
• Immune stimulants boost the immune system
when it is exhausted from fighting off prolonged
invasion or needs help to fight a specific
pathogen or cancer cell. They include
interferons and interleukins.
• Interferons are naturally released from cells in
response to viral invasion; they are used to
treat various cancers and warts.
• Interleukins stimulate cellular immunity and
inhibit tumor growth; they are used to treat
very specific cancers.
• Adverse effects seen with immune stimulants
are related to the immune response (flu-like
symptoms, including fever, myalgia, lethargy,
arthralgia, and fatigue).
• Immune suppressants are used to depress the
immune system when needed to prevent
transplant rejection or severe tissue damage
associated with autoimmune disease. Research
is ongoing to extend the use of various immune
suppressants to other situations, including
various autoimmune disorders.
• Increased susceptibility to infection and
increased risk of neoplasm are potentially
dangerous effects associated with the use of
immune suppressants. Patients need to be
protected from infection, injury, and invasive
procedures.
iV. Vaccines and Sera
Key Terms
• Active immunity
the formation of antibodies secondary to exposure
to a specific antigen; leads to the formation of
plasma cells, antibodies, and memory cells to
immediately produce antibodies if exposed to that
antigen in the future; imparts lifelong immunity
• Antitoxins
immune sera that contain antibodies to specific
toxins produced by invaders; may prevent the toxin
from adhering to body tissues and causing disease
• Antivenins
immune sera that contain antibodies to specific
venins produced by poisonous snakes or spiders;
may prevent the venom from causing cell death
 • Biologicals to facilitate an immune reaction, or to react
vaccines, immune sera, and antitoxins that are used to specifically with the toxins produced by an
stimulate the production of antibodies, to provide invading pathogen or venins injected by
preformed antibodies to facilitate an immune reaction, poisonous snakes or spiders.
or to react specifically with the toxins produced by an
Types:
invading pathogen
1. Vaccines
• Immune sera
preformed antibodies found in immune globulin from
2. Immune Sera
animals or humans who have had a specific disease and 3. Antivenins
developed antibodies to it. 4. Antitoxins
• Immunization
the process of stimulating active immunity by exposing
the body to weakened or less toxic proteins associated
with specific disease-causing organisms; the goal is to
stimulate immunity without causing the full course of a
disease
• Passive immunity
the injection of preformed antibodies into a host at high
risk for exposure to a specific disease; immunity is
limited by the amount of circulating antibody
• Serum sickness
reaction of a host to injected antibodies or foreign sera;
host cells make antibodies to the foreign proteins, and a
massive immune reaction can occur
• Vaccine Immunity
immunization containing weakened or altered protein • is a state of relative resistance to a disease that
antigens to stimulate a specific antibody formation develops after exposure to the specific disease-
against a specific disease; refers to a product used to causing agent.
stimulate active immunity Types:
• Active Immunity
DRUG LIST occurs when the body recognizes a foreign protein and
begins producing antibodies to react with that specific
protein or antigen
• Passive Immunity
occurs when preformed antibodies are injected into the
system and react with a specific antigen.

Vaccines
• comes from the Latin word for smallpox,
vaccinia.
• are immunizations containing
weakened(attenuated) or altered protein
antigens that stimulate the formation of
antibodies against a specific disease.
• are used to promote active immunity.
• can be made from chemically inactivated
Biologicals microorganisms or from live, weakened viruses
• are used to stimulate the production of or bacteria.
antibodies, to provide preformed antibodies
Key points
• Immunity is a state of relative resistance to
a disease that develops only after exposure
to the specific disease-causing agent.
• Vaccines provide active immunity by
stimulating the production of antibodies to
a specifi c protein, which may produce the
signs and symptoms of a mild immune
reaction but protects the person from the
more devastating effects of disease.
Immune Sera
 used to refer to sera that contain antibodies
to specific bacteria or viruses.
 are used to promote passive immunity.
 May contain antibodies to toxins, venins,
bacteria, viruses, or even red blood cell
antigenic factors.
 Also known as antitoxin have antibodies to
very specific toxins that might be released
by invading pathogens or antivenin which is
used to refer to immune sera that have
antibodies to venom that might be injected
through spider or snake bites.
 These drugs are used to provide early
treatment following exposure to known
antigens and are very specific for antigens
to which they can respond.
Key points
• Immune sera provide preformed antibodies
to specific proteins for people who have
been exposed to them or are at high risk for
exposure.
• The term immune sera typically refers to
sera that contain antibodies to specific
bacteria or viruses.
SUMMARY
• Immunity (relative resistance to a disease)
may be active or passive. Active immunity
results from the body making antibodies
against specific proteins for immediate
release if that protein reenters the body.
Passive immunity results from preformed
antibodies to a specific protein, which offers
protection against the protein only for the
life of the circulating antibodies.
• Immunizations are given to stimulate active
immunity in a person who is at high risk for
exposure to specific diseases.
Immunizations are a standard part of
preventive medicine.
• Vaccines can be made from chemically
inactivated microorganisms or from live,
 weakened viruses or bacteria. Toxoids are
vaccines that are made from the toxins
produced by the microorganism that are
altered so that they are no longer
poisonous but still have the recognizable
protein antigen that will stimulate antibody
production.
• Immune sera provide preformed antibodies
to specific proteins for people who have
been exposed to them or are at high risk for
exposure.
• The term immune sera typically refers to
sera that contain antibodies to specific
bacteria or viruses. Vaccines and Sera
Antitoxins are immune sera that have
antibodies to very specific toxins that might
be released by invading pathogens.
Antivenins are immune sera that have
antibodies to venom that might be injected
through spider or snake bites.
• Serum sickness—a massive immune
reaction— occurs more frequently with
immune sera than with vaccines. Patients
need to be monitored for any history of
hypersensitivity reactions, and emergency
equipment should be available.
• Patients should be advised to keep a written
record of all immunizations or immune sera
used. Booster doses for various vaccines
may be needed to further stimulate
antibody production.