Home Games & Quizzes History & Society Science & Tech Biographies Animals & Nature Geography & Travel Arts & Culture Money Videos
therapeutics
Table of Contents
References & Edit History Quick Facts & Related Topics
Images & Videos
Prozac immunization; vaccination
Causes of morning sickness explained
Rh hemolytic disease platelet classes of antibodies interferon atherosclerosis
Observe the subtle effects of the anticancer drug Taxol inside a cell
flat keloid
For Students
aspirin pills
therapeutics summary
Quizzes
A Yorkshire terrier dressed up as a veterinarian or doctor on a white background. (dogs)
A Visit with the Word Doctor: Medical Vocabulary Quiz
Read Next
false viper. Viper. Snake. Giant False Viper (Xenodon severus) in the Peruvian Amazon (aka Giant False Fer-de-Lance or Amazon False Fer-de-lance)
7 Bizarre Spa Treatments
Photo of the antacid Tums
How Do Antacids Work?
Discover
United States Electoral College votes by state
How Many Electoral College Votes Does Each U.S. State Have?
Artist interpretation of a Space meteoroid impact. Meteor impact. Asteroid, End of the world, danger, destruction, dinosaur extinct, Judgement Day, Planet Earth, Doomsday Predictions, comet
10 Failed Doomsday Predictions
Still from the film Deliverance, 1919. The story of Helen Keller and Anne Sullivan. View shows Keller in the cockpit/front seat of an airplane.
How Did Helen Keller Fly a Plane?
Pluto. The Changing Faces of Pluto. Most detailed view to date of the entire surface of the dwarf planet Pluto, as constructed from multiple NASA Hubble Space Telescope photographs taken from 2002 to 2003.
10 Important Dates in Pluto History
solar eclipse, sun, moon, astronomy, space
How Do You Tell the Difference Between Total, Annular, Solar, and Lunar Eclipses?
Solar eclipse of the sun.
The Sun Was Eaten: 6 Ways Cultures Have Explained Eclipses
In this aerial photo, structures are damaged and destroyed October 15, 2005 in Balakot, Pakistan. It is estimated that 90% of the city of Balakot was leveled by the earthquake. The death toll in the 7.6 magnitude earthquake that struck northern Pakistan on October 8, 2005 is believed to be 38,000 with at least 1,300 more dead in Indian Kashmir. SEE CONTENT NOTES.
6 of the World’s Deadliest Natural Disasters

Plasma

Plasma, the liquid portion of the blood, is more than 90 percent water. It contains all the noncellular components of whole blood including the coagulation factors, immunoglobulins and other proteins, and electrolytes. When frozen, the coagulation factors remain stable for up to one year but are usually transfused within 24 hours after thawing. However, some of the clotting factors, such as factor VIII (or antihemophilic factor, AHF) and factor V, are very labile even after the plasma is frozen and require the addition of stabilizing substances (e.g., glycine) or the use of special freezing procedures. Fresh frozen plasma is used in patients with multiple clotting factor deficiencies, such as in those with severe liver disease or massive hemorrhage.

Cryoprecipitate is prepared from fresh frozen plasma and contains about half the original amount of coagulation factors, although these factors are highly concentrated in a volume of 15–20 millilitres. Cryoprecipitate is used to treat patients with deficiencies of factor VIII, von Willebrand factor, factor XIII, and fibrinogen because it is rich in these factors.

Specific clotting factor concentrates are prepared from pooled plasma or pooled cryoprecipitate. Factor VIII concentrate, the antihemophilic factor, is the preferred treatment for hemophilia A. A monoclonal antibody–purified human factor VIII is also available. Factor IX complex, the prothrombin complex, is also available for treating hemophilia B (factor IX deficiency).

Immunoglobulins

classes of antibodies
classes of antibodies
The five main classes of antibodies (immunoglobulins): IgG, IgA, IgD, IgE, and IgM.

Immune serum globulin (ISG), obtained from the plasma of a pool of healthy donors, contains a mixture of immunoglobulins, mainly IgG, with lesser amounts of IgM and IgA. It is used to provide passive immunity to a variety of diseases such as measles, hepatitis A, and hypogammaglobulinemia. Intravenous immunoglobulins (IVIGs) provide immediate antibody levels and avoid the need for painful intramuscular injections.

Hyperimmune serum globulin is prepared in the same way as the nonspecific immunoglobulin above but from patients who are selected because of their high titres of specific antibodies. Rh-immune globulin is given to pregnant Rh-negative women to prevent hemolytic disease of the newborn. Other hyperimmune serum globulins are used to prevent hepatitis B, tetanus, rabies, and varicella-zoster (chickenpox or shingles) in exposed individuals.

Bone marrow transplantation

Bone marrow transplantation does not involve the transfer of a discrete anatomic organ, as occurs in other forms of transplantation, but it does carry the same risk of rejection by the recipient, which is called graft-versus-host disease (GVHD). The main indications for bone marrow transplantation are leukemia, aplastic anemia, and congenital immunologic defects.

Immunosuppressive drugs and irradiation are usually used to prepare the recipient. Close matching of tissue between donor and recipient is also essential to minimize GVHD, with autologous transplantation being the best method to avoid the disease (the patients donate their own bone marrow at times of remission to be used later). Allogeneic (homologous) bone marrow transplants by a matched donor (preferably a sibling) are the most common.

Bone marrow transplantation initially was not recommended for patients over age 50, because of the potential for increased mortality and morbidity and because the incidence of GVHD increases in those over age 30. Many transplant centres, however, have performed successful bone marrow transplantations in patients beyond age 50. People who donate bone marrow incur no risk, because they generate new marrow to replace that which has been removed. General anesthesia is required, however, to aspirate the bone marrow from the iliac crests; the marrow is then infused into the recipient.

Hematopoietic growth factors

The hematopoietic growth factors are potent regulators of blood cell proliferation and development in the bone marrow. They are able to augment hematopoiesis when bone marrow dysfunction exists. Recombinant DNA technology has made it possible to clone the genes responsible for many of these factors. Some are commercially available and can be used to stimulate white blood cell development in patients with neutropenia (a decrease in the number of neutrophilic leukocytes) associated with cancer chemotherapy.

The first to be developed was erythropoietin, which stimulates red blood cell production. It is used to treat the anemia associated with chronic renal failure and that related to therapy with zidovudine (AZT) in patients infected with HIV. It may also be useful in reversing anemia in cancer patients receiving chemotherapy. Filgrastim (granulocyte colony-stimulating factor [G-CSF]) is used to stimulate the production of white blood cells, which prevents infection in patients whose white blood cell count has diminished because of the effects of anticancer drugs. G-CSF also mobilizes stem cells, prompting them to enter the peripheral blood circulation. Stem cells can be harvested and used for bone marrow rescue. Another agent is sargramostim (granulocyte-macrophage colony-stimulating factor [GM-CSF]), which is used to increase the white blood cell count in patients with Hodgkin lymphoma or acute lymphoblastic leukemia who are undergoing autologous bone marrow transplantation.