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Immunity and Corticosteroids

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Can become anything they want to when they grow up. RBCs to carry oxygen ... Cortisone (Prototype Pro p 571) Prednisone, prednisolone. Glucocorticoids as meds ... – PowerPoint PPT presentation

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Title: Immunity and Corticosteroids


1
Immunity and Corticosteroids
  • Barbara S. Hays
  • Winter, 2006

2
Stem cells
  • Can become anything they want to when they grow
    up
  • RBCs to carry oxygen
  • WBCs to fight infection, tissue trauma
  • Platelets to begin the clotting process

3
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4
Red Blood Cells (Erythrocytes)
  • RBCs carry oxygen and carbon dioxide
  • Men (about 4.5 to 6.2 million/microliter)
  • Women (about 2.4 to 5.4 million)
  • Hemoglobin (heme porphyrin) plus globin
  • Men (about 14 18 grams/dl)
  • Women (about 12- 16 grams/dl)
  • Hematocrit
  • Men (about 45 57)
  • Women (about 37 47)

5
White Blood Cells (leukocytes)
  • Normal 4.500 to 11,000 per ml
  • Increased in
  • Infection
  • Leukemia
  • Tissue trauma/necrosis
  • Dehydration
  • Decreased
  • Bone marrow suppression (meds) most likely

6
White Blood Cells (leukocytes)
  • Differential classifies 100 WBCs as to type
  • Neutrophils 50 60
  • Fight infection, bacteria, tissue trauma
  • Banded neutrophils (bands) new, immature
  • Segmented neutrophils (segs) mature
  • Shift to the left
  • Eosinophils 1 4, allergy
  • Basophils 0.5 to 2 (allergy to some extent)
  • Lymphocytes 20 40 (fight viral, chronic
    bacterial infections)
  • B-cells (humoral immunity)
  • T-cells (cellular immunity)

7
Platelets
  • About 130,000 to 370,000 per ml
  • Danger of hemorrhage if less than 50,000
    (thrombocytopenia)

8
Types of Immunity
  • Active
  • Natural
  • Acquired
  • Passive
  • Natural
  • Acquired

9
Immunosuppressant agents(Easy p 577)
  • Used to treat autoimmune diseases and prevent
    transplant rejection
  • High risk of infections while on these drugs
    (some people are on them for life)
  • Azathioprine (Imuran)
  • Cyclosporine
  • Tacrolimus (Prograft, FK506)

10
Glucocorticoids
  • Classic antiinflammitory agents
  • think stabilizes cell membranes
  • think prevents vasodilation

11
Adrenal glands
  • Adrenal medulla
  • Adrenalin
  • Adrenal cortex
  • Salt
  • Sugar (stress hormones)
  • Sex

12
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13
Adrenal Cortex
  • SALT (mineralcorticoids)
  • SUGAR (glucocorticoids) Steroids
  • SEX (gonadocorticoids)

14
Mineralcorticoids salt
  • Aldosterone F/E balance
  • Hold on to sodium (and thus water)
  • Release potassium

15
Gonadocorticoids sex
  • Estrogens (female)
  • Androgens (male)

16
Glucocorticoids sugar
  • GLUCOSE metabolism
  • PROTEIN METABOLISM
  • FLUID/ELECTROLYTE balance
  • Anti-INFLAMMATION Anti-IMMUNITY
  • STRESS
  • EUPHORIA

17
Glucocorticoids
  • GLUCOSE metabolism
  • Conserve blood glucose
  • Promote gluconeogenesis

18
Glucocorticoids
  • PROTEIN metabolism
  • Catabolic part
  • Think fragile skin/tissues
  • Easy bruising
  • Ecchymosis

19
Glucocorticoids
  • FAT metabolism
  • Breakdown
  • Redistribution of body fat
  • Trunk/abdomen
  • Between shoulders
  • Face

20
Glucocorticoids
  • F/E balance similar to mineralcorticoids
  • Hold sodium (and thus hold water)
  • Release potassium

21
Glucocorticoids
  • ANTI-INFLAMMATORY and ANTI-IMMUNE response
  • Suppress inflammatory response
  • Suppress immune response
  • Lower circulating lymphocytes and eosinophils

22
Glucocorticoids
  • STRESS resistance
  • Physical
  • Mental
  • Emotional

23
Glucocorticoids
  • Euphoria feeling good, normal

24
Glucocorticoids as meds(Easy p 570 - 575
  • Steroids (catabolic)
  • Anti-inflammatory
  • Minimize allergic reactions
  • Briefly reduce lymphocytes in peripheral blood
  • Inhibit T-cell proliferation
  • Examples (sone or solone family)
  • Betamethasone
  • Cortisone (Prototype Pro p 571)
  • Prednisone, prednisolone

25
Glucocorticoids as meds
  • Concerns for nurses
  • Will mask symptoms of infections, diseases
  • Client susceptible to infection, but few s/s
  • Cause ulcers give with food
  • Cannot DC abruptly client could die

26
Glucocorticoids as meds
  • Danger
  • Osteoporosis, stunted growth
  • Masks symptoms client could be seriously ill
    with very few s/s
  • Diseases like TB

27
Side effects of corticoids
  • Hirsutism
  • Fragile tissues
  • Petechiae
  • ecchymosis
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