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Neutrophil
Neutrophil
Neutrophil
cell. They are very important as they carry oxygen from your lungs to all
parts of your body. White blood cells are just as important, but for a very different reason. One of their jobs is to protect you from infection.
There are several kinds of white cells. Each has a special function. The most common ones are: Neutrophils (pronounced NEW TROH FILS), which surround and destroy bacteria in your body; and
Lymphocytes (pronounced LIM FOH SITES), which are the key part of your bodys immune system, and defend against viruses.
A third kind of blood cell, the platelet, helps your blood to clot.
Normal neutrophil function depends on the integration of chemotaxis, phagocytosis,
degranulation and oxidative metabolism. As congenital and acquired neutrophil abnormalities increase the risk of infection, frequently with no other diagnostic features, diagnosis depends upon specialist laboratory investigations. Techniques for quantitative
What is neutrophil?
is a type of white blood cell in the granulocytic series, formed by myelopoietic tissue of the bone marrow (sometimes also in extramedullary sites), and released into the circulating blood, where they normally represent 5465% of the total number of leukocytes.
-A
type of white blood cell (WBC) filled with microscopic sacs (granules) containing
enzymes that digest bacteria and other microorganisms. This process is known as phagocytosis.
-Neutrophils
directly.
- Any cell or tissue that manifests no special affinity for acid or basic dyes, the cytoplasm stains approximately equally with either type of dye.
Neutrophils are the first type of immune cell to respond to and arrive at
the site of infection, often within an hour. They will respond to infection inside the body, but also on the surface, as in the case of skin infections.
Pus, which is one visible sign of a skin infection, contains mainly dead neutrophils, bacteria, and cells. Pus can form internally, as well.
The results of a common blood test, called an absolute neutrophil count (ANC), are routinely checked during cancer treatment to determine how
If ANC drops below about 500 cells per microliter, the risk of
-is a blood disorder where the body has an excessively low number of
one type of white blood cells known as neutrophil granulocytes, or neutrophils,. Around 50 to 70% of the white blood cells circulating around the body are made up of neutrophils. These white blood cells are responsible for attacking and eliminating
any bacteria that invade the body, and they function as the first line of
defense against infections. People who have Neutopenia are more vulnerable to bacterial infections, and if these infections are not treated
:
-bone marrow has a problem producing neutrophils in cases of cancer -Vitamin B12 or folic acid deficiency, -hereditary disorders like Congenital Neutropenia -exposure to pesticides -undergoing radiation therapy. -white blood cell destruction like aplastic anemia, Autoimmune Neutropenia, chemotherapy and hemodialysis treatments. -contracts a viral infection. (mild case)
Females have a higher risk for Neutropenia, as are elderly adults. A person with severe Neutopenia will need immediate medical attention, as there is a greater potential for
combined.
-can
hours.
- sufferers can develop the disease gradually, but are affected for
months, and even years. Chronic Neutropenia will often exhibit no symptoms until an infection sets in.
ofever
mouth ulcers o anal sores o ear and gum infections o tonsilitis o sore throats o skin abscesses o periodontal disease
o
diarrhea o swelling
o
In some cases, life-threatening infections or sepsis can set in, requiring hospitalization and intravenous administration of antibiotics. These infections usually manifest themselves in the mouth, throat, sinuses, lungs, and skin.
Is the development of fever, often with other signs of infection, in a patient with neutropenia, an abnormally low number of neutrophil
To diagnose Neutropenia, the doctor may order a complete blood count to determine the number of neutrophils in the blood. Sometimes, to make a precise diagnosis especially if the doctor suspects other serious illnesses, a bone marrow aspiration or biopsy may be necessary. In a bone marrow biopsy, the doctor will use a needle to take a sample of the patient's bone marrow and examine it under a microscope. The doctor will be looking for impaired neutrophil production, or if there has been excessive use or destruction of these cells. This test will show if there are any signs of an intrinsic defect in the marrow, Congenital Neutropenia, maturation arrest, a fungal infection, a lack of Vitamin B12 or a folate deficiency in the body. There may be other diseases present, as well, like leukemia, tuberculosis, and other cancers.
When the patient exhibits a form of Neutropenic fever, laboratory tests like blood cultures, urinalysis, Sputum Gram stain and culture, and measuring the serum Vitamin B12 and RBC folate levels may be recommended.
o o
round of antibiotics sargramostin (Leukine, Prokin), a blood growth factor that acts to stimulate the
B-complex vitamins and folic acid supplements,(For patients who have acquired spleen removal for patients who incur repeat infections because of Felty's syndrome
omedicated o o
colony-stimulating growth factors to induce white blood cell production corticosteroid treatment for Neutropenia caused by an autoimmune reaction globulin to treat symptoms of aplastic anemia,
oAntithymocyte o
bone marrow or stem cell transplant to treat more severe cases of Neutropenia like
People diagnosed with Neutropenia should avoid getting an infection by observing proper hygiene, keeping clean surroundings, and
There is an excellent prognosis for Neutropenia. Patients' recovery will depend on how severe the complications are. Usually, only 21% of patients incur serious complications, and recovery is even faster if the disease is diagnosed and treated immediately. In cancer
patients suffering from Neutropenia due to chemotherapy treatments, the mortality rate
is 4 to 30%. Scientists at the Northwest Hepatitis C Resource Center working on Neutropenia Prevention have recently found that using an alternative treatment combination of ribavirin, pegylated interferon, erthropoietin and ganulocyte colony-stimulating factor can control anemia and Neutropenia during anti-hepatitis C therapy. The use of acupuncture is another alternative therapy undertaken by the NESA
Severe chronic neutropenia can exist from birth (congenital neutropenia) or cn occur an any time through life (acquired neutropenia). It may develop by itself or as an accompanying symptom of a different underlying disease. The following list gives you examples of the different types of chronic neutropenias.
The following list gives you examples of the different types of chronic neutropenias.
Neutropenias present at birth:
Shwachman-Diamond syndrome
Glycogen-storage disease type 1b Idiopathic neutropenia Autoimmune neutropenia
Infection Table 1 : Causes of non-malignant Neutropenia Infection Immunologic diseases Human immunodeficiency virus Parvovirus Hepatitis viruses Malaria Isoimmune neonatal Neutropenia Autoimmune Neutropenia Felty's syndrome Rheumatoid arthritis Sjogren's syndrome Systemic lupus erythematosus
Drug Induced Neutropenia Hematologic diseases Congenital Neutropenia or Kostmann's syndrome Cyclic Neutropenia Childhood idiopathic Neutropenia Adult idiopathic Neutropenia Shwachman's syndrome Myelokathexis syndrome Congenital immunologic deficiency syndromes Aplastic anemia Myelodysplastic syndromes
This grave and unpredictable disorder is characterized by severe Neutropenia caused by an idiosyncratic reaction reaction to a drug that results in either direct suppression or
Analgesics/antiinflammatory agents
Aspirin Acetaminophen Phenylbutazone Sedatives Barbituates Benzodiazepines
Phenothiazines
Antirheumatics Gold Levamisole Penicillamine
What is Neupogen?
Neupogen (filgrastim) is a drug given to chemotherapy
your body, including bone marrow cells, which produce white and red
blood cells and platelets. Fewer bone marrow cells means less blood cells overall. If your CBC shows that your neutrophil count is low, you
pain
Fever
Self-Care Tips:
Soak Take
in a warm bath to help reduce bone pain. Tylenol (acetaminophen) to help lower mild fever and
reduce pain.
chest
pain
heart
palpitations
mouth
sores
pain
pain
Serious infections when less potentially dangerous drugs are ineffective or contraindicated Adults: 50 to 100 mg/kg/day I.V. in divided doses q 6 hours, to a maximum dosage of 4 g/day Children: 50 to 75 mg/kg/day I.V. in divided doses q 6 hours Bacteremia or meningitis Children: 50 to 100 mg/kg/day I.V. in divided doses q 6 hours Ocular infections Adults and children: Instill two drops of ophthalmic solution in each eye q.i.d. As supplement to solution, apply small amount of ophthalmic ointment to conjunctival sac at bedtime. (Solution and ointment may be used together or alone.)
Monitor patient for signs and symptoms of aplastic anemia, which may occur weeks or months after therapy ends. Monitor CBC count closely.
Instruct patient to report bleeding or bruising, even if therapy ended several weeks or months earlier. Tell patient to report rash or itching.
Caution patient to avoid pregnancy during therapy. If shes using hormonal contraceptives, advise her to use additional birth control method (drug may make hormonal contraceptives ineffective). As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.
Sulfonamides
sulfadiazine microsulfon Sulfonamides Urinary tract infections due to susceptible microorganisms, chancroid, acute otitis media, Hemophilus influenzae, and meningococcal meningitis, rheumatic fever. hematologic changes, Stevens- Johnson
Antithyroid Agents
Propythiouracil
PRESCRIBED FOR: PTU is used to manage hyperthyroidism associated with Graves' disease in patients who did not tolerate methimazole, and are not able to receive surgery or radioactive iodine therapy. It also is used to decrease symptoms of hyperthyroidism in preparation for surgical removal of the thyroid
gland or before radioactive iodine therapy in patients who did not tolerated
methimazole. DRUG INTERACTION : PTU may increase the effect of oral blood thinners, for example warfarin (Coumadin). Therefore, warfarin dose changes and monitoring for the effects of warfarin on blood clotting are necessary.
SIDE EFFECTS: The most common side effects are related to the skin and include rash, itching, hives, abnormal hair loss, and skin pigmentation. Other common side effects are swelling, nausea, vomiting, heartburn, loss of taste, joint or muscle aches, numbness and headache. Less common but serious side effects have occurred with PTU therapy. A decrease of white blood cells in the blood (agranulocytosis) may occur. Symptoms and signs of agranulocytosis include infectious lesions of
the throat, the gastrointestinal tract, and skin with an overall feeling of illness
and fever. A decrease in blood platelets (thrombocytopenia) also may occur. Since platelets are important for the clotting of blood, thrombocytopenia may lead to excessive bleeding. Severe liver injury and acute liver failure, in some cases fatal, have been associated with PTU. Some adults and pediatric patients required liver transplantation.
Tranquilizers
Action
Chlorpromazine
Unknown.May block postsynaptic dopamine receptors in brain and depress areas involved in
Preoperative sedation
Adults: 25 to 50 mg P.O. 2 to 3 hours before surgery, or 12.5 to 25 mg I.M. 1 to 2 hours before surgery Children ages 6 months to 12 years: 0.55 mg/kg P.O. (15 mg/m2) 2 to 3 hours before surgery, or 0.55 mg/kg I.M. 1 to 2 hours before surgery
Drug-behaviors. Alcohol use: increased CNS depression Sun exposure: increased risk of photosensitivity Patient monitoring Monitor blood pressure closely during I.V. infusion. Stay alert for signs and symptoms of neuroleptic malignant syndrome (hyperpyrexia,muscle rigidity, altered mental status, irregular pulse or blood pressure, tachycardia, diaphoresis, and arrhythmias). Stop drug immediately if these occur. Assess for extrapyramidal symptoms. Patient teaching Tell patient to take capsules or tablets with a full glass of water, with or without food. Instruct patient not to crush sustained-release capsules. Tell patient to mix oral concentrate in juice, soda, applesauce, or pudding.
Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.
PHENOTHIAZINES
USES: This medication is used to treat mental/emotional conditions. It is also used to treat nausea and vomiting and may be used for other conditions as determined by your doctor.
SIDE EFFECTS: Constipation, drowsiness, vision changes or dry mouth may occur. If any of these
effects persist or worsen, notify your doctor. This medication may cause dizziness and lightheadedness. To minimize these effects, get up slowly when rising from a seated or lying position. Unlikely to occur but report promptly: restlessness, muscle stiffness, weakness, difficulty
speaking, loss of balance, mask- like facial expression, trembling or shaking, dizziness, lip smacking
or other uncontrollable movements, difficulty urinating, skin rash/discoloration. Very unlikely to occur but report promptly: sore throat, unusual bleeding/bruising, stomach pain, yellowing of eyes/skin, dark urine, hot dry skin, vomiting. Though very unlikely to occur, notify your doctor
immediately if you experience any of the following effects: severe muscle stiffness, confusion, fever,
seizures, irregular/fast heartbeat, increased sweating, prolonged/painful erection. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other
Analgesics/antiinflammatory agents
Acetylsalicylic Acid (Aspirin) - Aspergum
Pharmacologic class: Non-steroidal anti-inflammatory drug (NSAID) Therapeutic class: Nonopioid analgesic, antipyretic, antiplatelet drug Pregnancy risk category C (with full dose in third trimester: D) Action - Reduces pain and inflammation by inhibiting prostaglandin production. - Fever reduction mechanism unknown; may be linked to decrease in endogenous pyrogens in hypothalamus resulting from prostaglandin inhibition. - Exerts antiplatelet effect by inhibiting synthesis of prostacyclin and thromboxane A2.
Adverse reactions
hearing loss nausea vomiting GI bleeding thrombocytopenia hyponatremia hypokalemia, hypoglycemia wheezing rash hypersensiti vity reactions
Patient monitoring
Watch for signs and symptoms of hypersensitivity and other adverse reactions, especially bleeding tendency.
Stay alert for signs and symptoms of acute toxicity, such as diplopia, ECG abnormalities, generalized seizures, hallucinations, hyperthermia, oliguria, acute renal failure, incoherent speech, irritability, restlessness, tremor, vertigo, confusion, disorientation, mania, lethargy, laryngeal edema, anaphylaxis, and coma.
Monitor elderly patients carefully because theyre at greater risk for salicylate toxicity.
With prolonged therapy, frequently assess hemoglobin, hematocrit, International Normalized Ratio, and kidney function test results. Check salicylate blood levels frequently. Evaluate patient for signs and symptoms of ototoxicity (hearing loss, tinnitus, ataxia, and vertigo).
Acetaminophen (N-acetyl-p-aminophenol)
Drug classes: Antipyretic Analgesic (nonopioid)
Therapeutic actions: Antipyretic: Reduces fever by acting directly on the hypothalamic heat-regulating center to
Indications:
Analgesic-antipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthritis Arthritis and rheumatic disorders involving musculoskeletal pain (but lacks clinically significant antirheumatic and anti-inflammatory
effects) Common cold, flu, other viral and bacterial infections with pain and fever Unlabeled
use: Prophylactic for children receiving DPT vaccination to reduce incidence of fever and pain
Nursing responsibilities.
Do
not exceed the recommended dosage. physician if needed for children < 3 yr; if needed for longer than 10 days; if
Consult
Carefully Give
Discontinue drug if hypersensitivity reactions occur. of overdose: Monitor serum levels regularly, N-acetylcysteine should be
Treatment