Allergies And Anaphylaxsis Flashcards
What forms can Antihistamine be given in
Can be given orally, nasally, eyes drops- used in allergies
What are the two generations of antihistamines
1st generation -more sedating
-alimemazine + promethazine more sedating that chlorphenamine + cyclizine
2nd generation- less sedating
Acrivastine, cetirizine, desloratadine, loratadine, fexofenadine
Can be used in nausea and vomiting, migraines and insomnia
-nausea and vomiting: cinnarizine, cyclizine and promethazine (first line for vomiting in pregnancy)
Migraines: buclizine
Occasional insomnia: 1st generation (promethazine)
What update has happened with fexofenidine
Can be sold OTC 120mg
Allergen immunotherapy
Immunotherapy: using allergens vaccines can reduce symptoms of asthma and allergic rhinoconjunctivitis
- can contain house dust mite, animal dander or pollen extract
Vaccines: contains bees/wasp venom extract reduces risk of severe anaphylaxis’s
Omalizumab: is a monoclonal antibody that binds to immunoglobulin E (igE)
-additional therapy is proven igE mediated sensitivity when severe persistent allergic asthma cannnot be controlled adequately with ICS + LABA
Side effects includes: Churg Strauss syndrome and hypersensitivity reactions
What is meant by Anaphylaxis
Severe life threatening hypersensitivity reactions- rapid developing airway/ circulation problem- usually caused by an allergen (food, drugs, venom, latex)
What do you do if someone is in anaphylactic shock
Use auto-injector immediately (IM adrenaline/epinephrine
Immediately call 999 and state anaphylaxis- administer CPR if needed
Lie down and raise the patients legs
Remove the trigger cause it the anaphylactic reaction if possible
Repeat after a 5 minute interval if there is no improvement in the patients condition
How do you treat anaphylaxis
High flow oxygen should be given as soon as possible
Intravenous fluids should be given to patients with hypotension/ shock
Following stabilisation of the patient, a non sedating oral antihistamine such as cetirizine hydrochloride
-if oral administration is not possible, intramuscular or intravenous chlorphenamine maleate can be given
Inhaled bronchodilator therapy with salbutamol and/or ipratropium bromide may also be considered for patients with persisting respiratory problems
What are the doses of auto injection pen for anaphylaxis
Childup to 6 months: 100-150 mcg
Child 6 months-5 years: 150mcg
Child 6-11 years old: 300mcg
Over 12: 500mcg
What is the MHRA alert on anaphylaxis
2 auto injection pens should be prescribed and carried at all times
