Allergy Colloquim Flashcards
Drugs and substances that may produce allergic reactions
- Local anaesthetics
- Antibiotics
- Analgesics
- Anxiolytic drugs
- Dental materials
Most common preservative in local anaesthetics that causes allergy
Paraben
Most common antibiotic producing allergic reaction
-Penicillin
Most common analgesics responsible for allergic reactions
- Codeine(narcotics)
- Aspirin (acetylsalicylic acid)-urticaria to anaphylactic shock
Anxiolytic drugs that commonly cause allergy
-Barbiturates (mild-urticaria)
Dental materials that commonly cause allergy
-Acrylic resins
-Antiseptics
-Radiograph processing solutions
-Gloves
(Mild-stomatitis and skin urticaria)
Classification of allergic reactions
- Type I- Anaphylaxis
- Type II- cytotoxic hypersensitivity
- Type III- Immune complex mediated hypersensitivity
- Type IV-Cell mediated or delayed type hypersensitivity
Types of allergic reactions
- Anapylaxis
- Urticaria
- Quinckes Edema
- Allergic Asthma
Precautionary measures for allergy
- Questions about type of allergy
- Referral for allergy testing
- Prepared to deal with allergic reaction with drugs(adrenaline, hydrocortisone, antihistamines and oxygen)
Anaphylaxis
- Acute respiratory and circulatory collapse
- Hoarseness of voice, anxiety, wheezing, irregular heart rate
- Fatal within 5-10 mins
Anaphylaxis treatment
- Termination of treatment-patient put in Trendelenburg position
- Adrenalin(0.3-0.5ml) giving i.v or i.m
- Control of vitals
- Hypotension treatment wit NaCl(i.v)
Anaphylactic shock treatment
- Adrenalin(0.5ml 0.1%) diluted in NaCl(o.9%) i.v
- Urbason (1-3mg/kg i.v)
- Salbutamol (5mg iv)
- Droperidol(for throes)
- CPR
Normal blood pressure for adult is
under 140/90mmHg
in patients with Bp of 140-160/90-95
- Can undergo dental surgery safely
- Above these values→ referred to doctor for further treatment
Hypertension management
- Premedication before surgery
- Bp monitoring
- Aspiration before injection
- Avoiding Noradrenaline
- Short appoitments
Hypertensive crisis
- Systolic >200/Diastolic >120mmHg
- Palpitations, increased heart rate, chest pain
- Headache
- Nausea, vomiting, tinitus
Hypertensive crisis treatment
- Nifedipin tablet(20mg) under toungue
- Isoket spray
Asthma
- Stenosis of bronchi and bronchioles(Bronchioconstriction, edema and mucous production)
- Expiratory dyspnoea accompanied by non productive cough and wheezing
Asthma preventative measures
- Detailed medical history
- Sedative medication for stress management
- Pain control(to manage stress)
- Short appoitments
Treatment of Asthma
- Termination of treatment
- Improve airway
- Salbutamol
- Adrenaline(0.1%)
- Methylprednisolon i.v
Diabetes mellitus
-Abnormalities in secretion mechanism and effect of insulin→ Alteration of carbohydrate, protein and lipid metabolism
Best time for surgery with diabetic patient
-Morning(1-1.5 h after breakfast)-peak insulin action
Administration of drugs for Diabetes Mellitus
- Mild analgesics and sedatives(w/tylenol) used
- Anxiolytic before procedure
- Corticosterioids(glycogenolytic action) and aspirin(hypoglycaemic action) avoided
Diabetic hypoglycaemia
- Blood glucose <55mg/100ml
- Hunger, sweating, pallor, headache, mental confusion, blurred vision
- More severe→loss of consciousness, coma and death
