Biologicals 生物制剂
Vaccines and immune sera, including antivenins and antitoxins, are usually referred to as biologicals. They are used to stimulate the production of antibodies, to provide preformed antibodies to facilitate an immune reaction, or to react specifically with the toxins produced by an invading pathogen or venins injected by poisonous snakes or spiders. Stimulating the production of antibodies to specific antigens with vaccines provides the person with immunity to that antigen.
Use of biologicals varies depending on different age groups.
生物制剂的应用跟人群有关。
CHILDREN 儿童
Routine immunization for children has become a standard of care in this country. Parents should receive written records of immunizations given to their children to assure continuity of care. The parent should be asked to report adverse reactions to any immunization. Sensitive children may receive divided doses of their immunizations to help prevent adverse reactions.
Simple comfort measures—warm soaks at the injection site, acetaminophen to reduce fever or aches and pains, comfort from parents or caregivers—will help the child to deal with the immunization experience.
Parent education is a very important aspect of the immunization procedure. Parents may need reassurance and educational materials when concerns about the safety of immunizations arise.
家长教育是免疫程序一个极为重要的方面。父母担心免疫安全性时也可能需要一些安慰和教育材料。
Immune sera are used for specific exposures. Botulism immune globulin is specific for treatment of infants younger than 1 year of age with botulism.
免疫血清用于一些特殊的暴露接触。肉毒杆菌免疫球蛋白专门用于治疗1岁以下儿童的肉毒杆菌。
ADULTS 成人
There are a number of reasons why adults should receive certain immunizations. For example, adults who are traveling to areas with high risk for particular diseases—and who may not have previously been exposed to those diseases—are advised to be immunized.
In addition, adults with chronic diseases are advised to be immunized yearly with an influenza vaccine and once with a pneumococcal pneumonia vaccine. These vaccines provide some protection against diseases that can prove dangerous for people with chronic lung, cardiovascular, or endocrine disorders. The influenza vaccine changes yearly, depending on predictions of which flu strain might be emergent in that year. The pneumonia vaccine contains 23 strains and is believed to offer lifetime protection.
Tetanus shots also are recommended for adults every 10 years or with any injury that potentially could precipitate a tetanus infection. Immune sera are used for specific exposures.
OLDER ADULTS 老人
Older patients are at greater risk for severe illness from influenza and pneumococcal infections. The yearly flu shot and the pneumococcal vaccine should be stressed for this group.
A tetanus booster every 10 years will also help to protect older adults from exposure to that illness. Ask the patient about any adverse reaction to previous tetanus boosters, and weigh the risk against the possible exposure to tetanus. If an older patient is traveling to an area where a particular disease is endemic and the risk of exposure is great, the Centers for Disease Control and Prevention should be contacted to determine whether the appropriate vaccine is acceptable for use in the older patient.
Immune sera are used for specific exposures. Older adults are at increased risk for severe reactions and should be monitored closely.
有些接触暴露则需要免疫血清。老人对严重反应的风险较高，应密切监测。
★Vocabulary for Today ★
biological – n. 生物制剂
immune sera – 免疫血清
antivenin – n. 抗蛇毒素，抗蛇毒血清
antitoxin – n. 抗毒素
toxin – n. 毒素
venin – n. 蛇毒，动物毒素
continuity of care – 医疗连续性
parent education – 亲职教育，家长教育
botulism – n. 肉毒中毒，肉毒杆菌毒素
influenza vaccine – 流感疫苗
pneumococcal pneumonia – 肺炎球菌性肺炎
shot – n. 注射，疫苗
booster – n. 加强（剂量）
tetanus – n. 破伤风
★Video ★
Immunization Schedule
★Test ★
1. A parent asks, “Can I get head lice too?” The nurse indicates that adults can also be infested with head lice but that pediculosis is more common among school children, primarily for which of the following reasons?
A. An immunity to pediculosis usually is established by adulthood.
B. School-age children tend to be more neglectful of frequent handwashing.
C. Pediculosis usually is spread by close contact with infested children.
D. The skin of adults is more capable of resisting the invasion of lice. 2. The nurse is teaching a 17-year-old girl who has a severe gonorrheal infection. The nurse realizes that the girl understands the implications of her disease when she tells the nurse:
A. “Once I’m treated, I’ll have immunity.”
B. “My partner doesn’t need treatment.”
C. “I won’t have any more problems once I learn to protect myself.”
D. “I could have trouble getting pregnant.”
答案 Key to Questions
1. C. Pediculosis usually is spread by close contact with infested children.
Rationale: Lice are spread by close personal contact and by contact with infested clothing, bed and bathroom linens, and combs and brushes. Lice are more common in school-age children than in adults because of the close contact in school and the common practice of sharing possessions. Lice are not commonly spread by hand contact. There is no immunity conferred by having head lice. Adults can have head lice, particularly if they come in close contact with their children’s infested clothing or linens. 2. D. “I could have trouble getting pregnant.”
Rationale: With a severe gonorrheal infection, scarring of the fallopian tubes may occur, and becoming pregnant may be diffi cult or impossible. If the girl’s partner is not treated, she can be reinfected. There is no immunity against gonorrhea and, if exposed again, the girl can again become infected. Although a condom may provide some protection against contracting gonorrhea, it is not an adequate protection against the condition and will not help clear up an existing infection. It is only with proper antibiotic administration that the condition can be eradicated.
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