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Clinical 1 (Part A) > Anaphylaxis > Flashcards

Anaphylaxis Flashcards

1
Q

Briefly describe Anaphylaxis

A
  • systemic hypersensitivity rxn
  • serious allergic rxn
  • rapid in onset
  • could cause death
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2
Q

What % of anaphylaxis presents skin irritation?

A

80-90 %

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3
Q

Urticaria

A

Hives

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4
Q

Describe the pathophysiology of an immunologic anaphylaxis rxn

A
  • during initial exposure an individual will transform IgE antibodies to an antigen
  • when individual is exposed to antigen, it binds to IgE antibodies
  • this triggers release of vasoactive and inflammatory mediators from mast cells and basophils
  • ALSO RELEASES HISTAMINE
  • leads to potential development of urticaria, angioedema, bronchospasm, hypotension, GI symptoms
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5
Q

When do symptoms usually occur after exposure?

A

30 mins (but could happen hours after)

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6
Q

angioedema

A

swelling

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7
Q

bronchospasm

A

difficulty breathing

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8
Q

hypotension

A

drop in BP

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9
Q

3 categories of human anaphylaxis

A
  • immunologic (IgE mediated rxns)
  • non immunologic (identical rxns that are not immunologically mediated)
  • idiopathic (unknown cause)
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10
Q

understand clinical criteria

A

ok man

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11
Q

What are the 3 types of potential patterns of anaphylactic rxns?

A
  • uniphasic (1 phase)
  • biphasic (2 phases - symptoms reappear)
  • protracted (severe rxn that lasts for more than 24 hrs)
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12
Q

What is recommended for Pt’s after they use an epipen?

A

seek medical attention

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13
Q

Describe examples of a cutaneous rxn to anaphylaxis

A
  • hives/welts
  • itching
  • flushed/redness of the skin
  • swelling
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14
Q

Describe examples of a respiratory rxn to anaphylaxis

A
  • throat or chest tightness
  • difficulty breathing
  • wheeze
  • cough
  • swelling of tongue, lips, uvula, palate
  • itching of throat
  • itchy nose, congestion, runny/sneezing nose
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15
Q

Describe examples of GI rxn to anaphylaxis

A
  • difficulty/pain swallowing
  • nausea/vomitting
  • abdominal cramping
  • diarrhea
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16
Q

Describe examples of cardiovascular rxn to anaphylaxis

A
  • hypotension (drop in BP)
  • chest pain
  • dysrhythmias (abnormal rhythm of the heart)
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17
Q

List a few other common rxns to anaphylaxis

*See pg 2/7 in notes

A
  • lightheadedness
  • dizziness
  • sweating
  • feeling of doom lol
  • uneasiness
  • headache

etc
etc

**children may display sudden behavioural changes

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18
Q

Give examples of common triggers of anaphylaxis

A
  • foods
  • drugs
  • insect stings
  • latex
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19
Q

List the 3 key parts of treatments for anaphylaxis in the community setting

A
  • CPR (if breathing is affected)
  • epinephrine (inj immediately and repeat in 10 mins if required)
  • seek medical attention
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20
Q

What schedule are epinephrine auto injectors?

A

schedule 2 (don’t need an Rx, but held behind counter and require pharmacist consultation)

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21
Q

Describe the MOA (mechanism of action) of epinephrine auto injectors

A
  • acts on alpha and beta-adrenergic receptors
  • leads to restoration of respiratory and cardiovascular function by:

-relaxing bronchial smooth muscle (helps open airways)

-vasoconstriction to stop the vasodilation causing hypotension in anaphylaxis
(increase BP back to normal)

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22
Q

Where is the recommended administration of an epipen?

A

intramuscularly in the mid to outer part of thigh

23
Q

Describe the action and duration of epipens?

A

rapid onset

short duration

24
Q

When should pt’s feel improvement after injection of epinephrine?

A

5-10 mins

25
Q

Why do we inject into the thigh?

A

-great blood supply

26
Q

What is the dose for the adult epipen?

A

0.3mg/dose

27
Q

What is the dose for the epipen jr?

A

0.15mg/dose

28
Q

Are there any contraindications of epinephrine?

A

no absolute contraindications

29
Q

What are a few common adverse effects of epinephrine?

A
  • anxiety
  • tremors
  • pallor
  • tachycardia (increase HR)
30
Q

What is the acronym for what to watch for when expecting an allergic rxn?

A

FAST

Face - hives, itching, redness, swelling of face, lips, or tongue

Airway - restricted speaking, swallowing, or breathing

Stomach - stomach pain, vomiting, diarrhea

Total body - hives, itching, swelling, weakness

31
Q

____ hives are present for less than 6 wks

A

acute

32
Q

____ hives are recurrent with signs and symptoms recurring most days of the week, for six weeks or longer

A

chronic

33
Q

Describe the appearance of hives

A
  • smooth
  • can be elevated
  • discolored

itchy!

34
Q

What can cause hives?

A
  • allergic rxns
  • infections
  • illnesses
  • exposure to sun, heat, cold, or water
  • exercise
  • stress
  • contact w chemicals
  • scratching the skin
35
Q

Recommended treatment for acute urticaria?

A

oral anti-histamines

36
Q

Describe general treatment of insect bites and stings (5)

A
  • remove insect/stinger
  • ice to reduce swelling
  • clean area well
  • non-Rx oral anti-histamines
  • non-Rx topical steroid to relieve inflammation and itching
37
Q

Describe the 6 OTC treatment options for insect bites and stings

A
  • topical corticosteroids
  • oral antihistamines
  • skin protectants
  • topical anesthetics
  • topical antihistamines
  • topical counterirritants
38
Q

What is the difference between an anesthetic and an analgesic?

A

Anesthetic: induces insensitivity to pain

Analgesic: relieves pain

39
Q

What do counterirritants do?

A

-depress cutaneous receptors resulting in relief of itching and irritation due to anesthetic

40
Q

Do topical anesthetics have a short or long duration?

A

short (between 15 and 45 mins)

41
Q

List some examples of topical anesthetics

A

benzocaine
lidocaine
pramoxine

42
Q

What risk do topical anesthetics pose?

A

hypersensitivity rxn and systemic absorption/toxicity

43
Q

T or F: drugs ending in “caine” are less common to pose a hypersensitivity risk than drugs with a different ending

A

false

-more common

44
Q

How do topical antihistamines work?

A

They cause an anesthetic effect by DEPRESSING CUTANEOUS RECEPTORS to relieve pain and itching

45
Q

What is more effective usually: oral or topical anesthetics

A

oral

46
Q

Give an example of a topical antihistamine

A

topical diphenhydramine (benadryl)

47
Q

What do skin protectants do?

A

reduce inflammation and irritation

48
Q

Give 2 examples of skin protectants

A

zinc oxide

calamine

49
Q

What are the 2 oral treatments for insect bites and stings

A
  • analgesics (pain relief)

- oral antihistamines (relief of itching, inflammation and pain)

50
Q

Give examples of oral analgesics (4)

A
  • acetaminophen
  • ASA
  • naproxen
  • ibuprofen
51
Q

Antipruritic

A

anti-itch

52
Q

explain how topical corticosteroids works

A

Produce antipruritic and anti-inflammatory actions that can prevent or suppress development of edema, capillary dilation, swelling and tenderness

53
Q

Edema

A

fluid collection

54
Q

Discuss the 5 monitoring parameters

A
  • pain/fever
  • itching
  • swelling/redness
  • signs of infection
  • anaphylactic rxn

Clinical 1 (Part A) (15 decks)

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