Anaphylaxis Flashcards
Adverse drug reactions – Rawlins Thompson classification
Type A – (augmented pharmacological) – predictable, dose-dependent, common
Type B – (bizarre or idiosyncratic) – not predictable and not dose-dependent
Type C – (chronic) – osteoporosis and steroids
Type D – (delayed) – malignancies after
immunosuppression
Type E – (end of treatment) – occurs after abrupt drug withdrawal.
Type F – (failure of therapy) – failure of the oral contraceptive pill in the presence of enzyme inducer
What is an example of an adverse drug reaction
- Beta-blockers
- Bradycardia and heart block are the primary adverse effects
- Bronchospasm is a secondary pharmacological adverse effect
Define side effects
an unintended effect of a drug-related to its pharmacological properties and can include unexpected benefits of treatment
Define adverse drug reaction
unwanted or harmful reactions following the administration of drugs or combination of drugs under normal conditions of use and is suspected to be related to the drug
What does adrenaline do once administered regarding anaphylaxis
- Vasoconstriction – increase in peripheral vascular resistance, increased BP and coronary perfusion
- Stimulation of beta1-adrenoceptors positive ionotropic and chronotropic effects on the heart
- Reduces oedema and bronchodilates via beta2-adrenoceptors
What is anaphylaxis
acute allergic reaction to an antigen to which the body has become hypersensitive
a most severe form of type 1 hypersensitivity
- Margination Slowing of blood velocity to allow neutrophils to line up along endothelium.
- Adhesion “Sticking” of neutrophils to endothelium via adhesion molecules
- Emigration Neutrophils move through the walls of small blood vessels
- Diapedesis Where red cells passively escape the circulation due to hydrostatic pressure
- Chemotaxis Where neutrophils follow a concentration gradient of certain compounds
Tumour
Papilloma – benign tumour of non-glandular, non-secretory epithelium.
* Adenoma – benign tumour of glandular or secretory epithelium
*Carcinoma- malignant tumour of non-glandular, non-secretory epithelium
*Adenocarcinoma – malignant tumour of glandular or secretory epithelium
*Sarcoma – malignant tumour of connective tissue (e.g. liposarcoma, rhabdomyosarcoma)
Pharmacodynamics vs Pharmacokinetics
- Pharmacodynamics – what the drug does to your body
- Pharmacokinetics – what your body does to the drug
Gram-positive vs Negative
- Gram positive – thick peptidoglycan
- Gram negative – 2 phospholipid membranes. Also has lipopolysaccharides
list of the structures/processes which antibiotics interact with
Cell wall - Beta lactams, vancomycin
* DNA gyrase – quinolones
* Folate synthesis – sulphonamides, trimethoprim
* 30s subunit – tetracyclines, aminoglycosides
* 50s subunit – macrolides, clindamycin
Mycobacteria are
Mycobacteria are slow growing, and predominantly immobile (A), rod shaped (B), intracellular (C) and gram positive
SIADH causes a state is known as
euvolaemic hyponatraemia –
● Hyponatraemia – low blood sodium concentration due to excess water reabsorption.
● Euvolaemic meaning no signs of hypervolaemia (fluid overload) or hypovolaemia (dehydration). The extra water reabsorbed is not usually significant enough to cause fluid overload.
Tolvaptan is a
vasopressin antagonist
Hypo vs hypercalcaemia
Haemodymaically stable vs unstable for Atrial fibrillation
● Haemodynamically unstable – cardioversion with synchronised DC shock + anticoagulation.
● Haemodynamically stable – either:
○ Rate control (Beta blockers / CCBs) + anticoagulation
○ Rhythm control (cardioversion) -> beta blockers + anticoagulation
How does C.diff spread
Faecal oral route
What is Meckels diverticulum
The vitelline duct is an embryonic structure providing communication from the yolk sac to the midgut during foetal development. It is located proximal to the ileocaecal valve (within the ileum).
It usually obliterates spontaneously and separates from the intestine between approximately the 5th and 9th weeks of gestation. If the vitelline duct remains it can form a Meckel diverticulum. This can present with rectal bleeding in children.
1st line investigation for coeliac
The 1st line investigation is the IgA-tissue transglutaminase blood test
Internal rotation of shoulder
Subscapularis is responsible for shoulder internal rotation.
SLE hypersenstivity reaction
1
mechanism by which alcohol consumption causes polyuria.
Ethanol suppressing ADH secretion from the posterior pituitary gland.
Which of the following is not a well-recognised type of renal stone?
A) Monosodium Urate.
B) Calcium Oxalate.
C) Struvite.
D) Cystine.
E) Calcium Pyrophosphate.
Calcium Pyrophosphate.
nimodipine action
A calcium channel blocker which reduces cerebral artery spasm thus preventing ischaemia
