ECITS Flashcards
Antibodies a.k.a.
Immunoglobulin (Ig)
Where are IgE antibodies located
On basophil and mast cells
Diseases such as asthma, allergic rhinitis and dermatitis predispose some one to the potential for what type of reaction
anaphylaxis
Describe collagen vascular disease
an autoimmune disorder where the body perceives its own tissues and cells to be forgein invaders
Systemic Lupus Erythematosis
Scleroderma
Immune suppression is important in the treatment
Why is the suppression of the immune system important to organ transplant patients
So that the body does not recognize the new organ as forgiven and attempt to destroy it.
Infection is the greatest risk to survival for these patients
The primary immune response begins with what actions
Macrophages engulfing an invader
Immune cells record the proteins of the invader and manufacture antibodies against it
Through the primary response the body develops what
Sensitivity
What are the systemic effects of chemical mediators
S&Sy of allergic reactions and anaphylaxis
What is the secondary immune response composed of
acquired immunity and natural immunity
What does a mild reaction effect
A localized area of the body
What does a moderate reaction effect
Begins as a mild reaction but spreads to other areas of the body
What is a severe reaction classified as
anaphylaxis, potentially life-threatening
Classic presentation of anaphylaxis includes what 2 body systems
respiratory and skin
Describe the airway response of an anaphylaxis reaction
Wheezing, stridor due to bronchoconstriction, excessive mucus production and increased edema
Exhalation becomes increasingly difficult
Typical cardiovascular signs of anaphylaxis
Vasodilation, tachycardia, hypotension
Shock
What may the ETCO2 levels show in an anaphylaxis response
Elevated due to air trapping with shark fin wave forms
What position should you place the patient in in an anaphylaxis response
Trendelenburg’s
To maintain cerebral perfusion (shock)
Primary chemical mediator
Histamine
Causes vasodilation and capillary permeability
How does histamine release typically present in a patient
Vasodilation, hypotension, erythematous, edema, urticaria, smooth muscle contraction (larygospasm, bronchoconstriction, abdominal cramping) and fluid loss
Leukotriene release causes what
additional bronchoconstriction, coronary vasoconstriction, and increased vascular permiability, decrease in cardiac contractility and decrease in cardiac output
What is pruritus
itching
Think of a patient in anaphylaxis as experiencing what 3 types of shock
Cardiogenic
Hypovolemic
Neurogenic
Whenever dyspnea is present in conjunction with S&Sy of allergic reaction what is the first line of action
administer .3mg 1:1000 epi IM
Considerations in IV access
2 large bore IV’s
administer 1-2L of NS
monitor lung sounds
What classification is diphenhydramine and how does it work
Anti-histamine
Does not inhibit histamine release but blocks the H1 and H2 receptor sites
In an anaphylaxis response when should diphenhydramine be administered
after epi is on board
Why are corticosteroids administered in a severe allergic response
They help prevent a biphasic response
Why would glucagon be administered in anaphylaxis
If the pt were on B-blockers and epinepherine was ineffective
It increases cardiac contractility
Glucagon dose in anaphylaxis
1-2mg IM/IV q 5 min
If patient does not respond to fluid administration what medication may be considered
Dopamine infusion
What % of patients will have a reoccurrence of the S&Sy in the next 8 hrs
20%
