Allergic Response Flashcards
What is a type I allergic reaction?
Anaphylaxis - severe whole body reaction to substance that has become an allergen. Antigens bind IgE on mast cells. Fluid extravasates into perivascular space. Also asthma and atopy.
What is a type II allergic reaction?
Cytotoxic - Antibody binds to foreign cells leading to cell destruction via membrane attack complex. (ex. ABO incompatibility, drug-induced hemolytic anemia, heparin-induced thrombocytopenia)
What is a type III allergic reaction?
Immune complex - Antibody binds to foreign cells leading to cell destruction via neutrophils. Inflammation observed.
What molecular structure within antibiotics are allergies typically to?
The beta lactam ring
What antibiotic is often instead of penicillin if pt has allergy?
Vancomycin, ciprofloxin
What might be responsible for a “lidocaine allergy?”
May be misdiagnosis, or may be normal response to drugs, such as tinnitus or palpitations if given with epi.
Which type of LA’s are people usually allergic to?
Ester - to PABA metabolite
What type of drug do patients most commonly have an allergic reaction to?
Muscle relaxants (metaxalone)
What in the OR is latex?
Gloves, tops of drug vials, Swan Ganz catheter
What do H1 histamine receptors trigger?
Smooth muscle contraction, wheezing, itch, sneezing
What do H2 histamine receptors trigger?
Increased H+ secretion, gastric volume, and increased heart rate
What do H3 histamine receptors trigger?
Inhibit histamine release (negative feedback)
What are intraop signs of an allergic reaction?
Facial edema, rash, bronchospasm (decreased TV or high PIP), hypotension, tachycardia
Treatments for allergic reaction?
Antihistamines (diphenhydramine 0.5-1mg/kg), bronchodilators, steroids, removing offending agent, Epi
How to confirm anaphylaxis reaction?
Check histamine levels, get tryptase labs, do skin intradermal testing (RAST, ELISA)
