Allergy and anaphylaxis

Question 1

what forms do antihistamines come in?

Answer 1

oral, topical , nasal , eye drops used in allergies

Question 2

what are some examples of 1st gen antihistamines? more sedating?

Answer 2

-alimemazine + promethazine more sedating than chlorphenamine + cyclizine

Question 3

what are some examples of 2nd gen antihistamines?

Answer 3

less sedating
-acrivastine, cetirizine, desloratadtine, loratidine and fexofenadine

Question 4

what is new update with fexofenadine?

Answer 4

fexofenadine is now OTC at 120mg

Question 5

antihistamines can also be used for what?

Answer 5

vomitting, migraines and insomnia

Question 6

what antihistamine are used for N+V?

Answer 6

cinnarizine, cyclizine, promethazine (first line V in pregnancy)

Question 7

what is used for migraines?

Answer 7

migraines buclizine

Question 8

what can be used for occasional insomnia?

Answer 8

1st gen
promethazine

Question 9

what can be considered if allergies are really bad?

Answer 9

allergen immunotherapy

Question 10

what is immunotherapy?

Answer 10

using allergen vaccines can reduce symptoms of asthma and allergic rhinoconjuctivitis

Question 11

what do the vaccines contain in allergen immunotherapy?

Answer 11

-house dust mites, animal dander or pollen extract

Question 12

what can vaccines containing bee/wasp venom be used for?

Answer 12

reduced risk of severe anaphylaxis

Question 13

what is omalizumab? SE

Answer 13

a monoclonal antibody that binds to ummunogloblin E
-SE charge-strauss syndrome and hypersensitivity reaction

Question 14

what is anaphylaxis?

Answer 14

-severe life threatening hypersensitivity reaction- rapidly developing airway/circulation problems usually by allergens (food, drugs, venom, latex)

Question 15

how do you deal with anaphylaxis?

Answer 15

-use auto-injector immediately (IM adrenaline/epinephrine)
-immediately call 999 and state anaphylaxis-administer administer CPR if needed
-lie down and raise legs
-remove triggers causing the anaphylactic reaction if possible
-repeat after 5-mins interval if there is no improvement in the patients condition

Question 16

what is the treatment in hospital for anaphylaxis ?

Answer 16

-high flow oxygen should be given asap
-IV fluids to help treat the hypotension and shock
-follwoing stablisation of the patient, a non-sedating oral antihistamine such as cetirizine hydrochloride- If oral admin isn’t possible then IM or IV chlorophenMINE MALEATE CAN BE GIVEN
-Salbutamol and /or ipratropium bromide can b considered for patients with persisting respiratory problems

Question 17

what are the doses for adrenaline?

Answer 17

-children up to 6months: 100-150mcg
-children 6 months- 5 years 150mcg
-child 6-11 years: 300mcg
-over 12 years: 500mcg

2 auto injectors should be prescribed and carried at all times