Allergy Colloquim

Question 1

Drugs and substances that may produce allergic reactions

Answer 1

• Local anaesthetics
• Antibiotics
• Analgesics
• Anxiolytic drugs
• Dental materials

Question 2

Most common preservative in local anaesthetics that causes allergy

Answer 2

Paraben

Question 3

Most common antibiotic producing allergic reaction

Answer 3

-Penicillin

Question 4

Most common analgesics responsible for allergic reactions

Answer 4

• Codeine(narcotics)
• Aspirin (acetylsalicylic acid)-urticaria to anaphylactic shock

Question 5

Anxiolytic drugs that commonly cause allergy

Answer 5

-Barbiturates (mild-urticaria)

Question 6

Dental materials that commonly cause allergy

Answer 6

-Acrylic resins
-Antiseptics
-Radiograph processing solutions
-Gloves
(Mild-stomatitis and skin urticaria)

Question 7

Classification of allergic reactions

Answer 7

• Type I- Anaphylaxis
• Type II- cytotoxic hypersensitivity
• Type III- Immune complex mediated hypersensitivity
• Type IV-Cell mediated or delayed type hypersensitivity

Question 8

Types of allergic reactions

Answer 8

• Anapylaxis
• Urticaria
• Quinckes Edema
• Allergic Asthma

Question 9

Precautionary measures for allergy

Answer 9

• Questions about type of allergy
• Referral for allergy testing
• Prepared to deal with allergic reaction with drugs(adrenaline, hydrocortisone, antihistamines and oxygen)

Question 10

Anaphylaxis

Answer 10

• Acute respiratory and circulatory collapse
• Hoarseness of voice, anxiety, wheezing, irregular heart rate
• Fatal within 5-10 mins

Question 11

Anaphylaxis treatment

Answer 11

• 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)

Question 12

Anaphylactic shock treatment

Answer 12

• 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

Question 13

Normal blood pressure for adult is

Answer 13

under 140/90mmHg

Question 14

in patients with Bp of 140-160/90-95

Answer 14

• Can undergo dental surgery safely
• Above these values→ referred to doctor for further treatment

Question 15

Hypertension management

Answer 15

• Premedication before surgery
• Bp monitoring
• Aspiration before injection
• Avoiding Noradrenaline
• Short appoitments

Question 16

Hypertensive crisis

Answer 16

• Systolic >200/Diastolic >120mmHg
• Palpitations, increased heart rate, chest pain
• Headache
• Nausea, vomiting, tinitus

Question 17

Hypertensive crisis treatment

Answer 17

• Nifedipin tablet(20mg) under toungue
• Isoket spray

Question 18

Asthma

Answer 18

• Stenosis of bronchi and bronchioles(Bronchioconstriction, edema and mucous production)
• Expiratory dyspnoea accompanied by non productive cough and wheezing

Question 19

Asthma preventative measures

Answer 19

• Detailed medical history
• Sedative medication for stress management
• Pain control(to manage stress)
• Short appoitments

Question 20

Treatment of Asthma

Answer 20

• Termination of treatment
• Improve airway
• Salbutamol
• Adrenaline(0.1%)
• Methylprednisolon i.v

Question 21

Diabetes mellitus

Answer 21

-Abnormalities in secretion mechanism and effect of insulin→ Alteration of carbohydrate, protein and lipid metabolism

Question 22

Best time for surgery with diabetic patient

Answer 22

-Morning(1-1.5 h after breakfast)-peak insulin action

Question 23

Administration of drugs for Diabetes Mellitus

Answer 23

• Mild analgesics and sedatives(w/tylenol) used
• Anxiolytic before procedure
• Corticosterioids(glycogenolytic action) and aspirin(hypoglycaemic action) avoided

Question 24

Diabetic hypoglycaemia

Answer 24

• Blood glucose <55mg/100ml
• Hunger, sweating, pallor, headache, mental confusion, blurred vision
• More severe→loss of consciousness, coma and death

Question 25

Diabetic hypoglycaemia treatment

Answer 25

• Termination of treatment
• Sugar or honey
• 1mg Glucagon

Question 26

Diabetic hyperglycaemia

Answer 26

• More rare
• Slow development
• Weakness, headache, nausea,, xerostomia, dehydration→coma

Question 27

Diabetic hyperglycaemia

Answer 27

• Termination of treatment
• Full dose of insulin