Module 3- Child Urticaria/anaphylaxis/adverse reactions/allergies Flashcards

1
Q

Urticaria

A

arbitrarily designated as acute, lasting less than 6 weeks, or chronic, lasting more than 6 weeks. It is also classified by trigger: allergic, physical/inducible, infectious, autoimmune, or spontaneous/idiopathic
Viral infections are identified as the cause of acute urticaria
chronic urticaria, infections are considered an exacerbating factor

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2
Q

urticaria or angioedema pathogenesis

A

Mast cells release of a variety of vasoactive mediators triggered by different stimuli, including cross-linking of Fc receptor–bound IgE by allergens or anti-FcεRI antibodies

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3
Q

Inducible (physical) urticarias

A

heterogeneous group of disorders in which urticaria or angioedema is triggered by physical stimuli, including pressure, cold, heat, water, or vibrations

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4
Q

Dermographism

A

most common form of physical urticaria, occurring at skin sites subjected to mechanical stimuli

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5
Q

S & S- Urticaria

A

wheals with reflex erythema that are pruritic and transient, resolve w/out any changes to the skin
Systemic features include headache, wheezing, and syncope

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6
Q

S&S of angioedema

A

rapid erythematous or skin-colored swelling that is associated with burning or pain more than pruritus

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7
Q

Lab findings for Urticaria and angioedema

A

Testing for specific IgE antibody to food or inhalant allergens or infections may be helpful,

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8
Q

Treatment- General measures Urticaria and angioedema

A

effective treatment is identification and avoidance of the triggering agent, Underlying infection should be treated appropriately,

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9
Q

Antihistamines

A

H1 antihistamines given orally or systemically are the mainstay of therapy, second-generation H1 antihistamines are first-line tx, if urticaria is refractory then increase dose by 4folds

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10
Q

Other Pharmacologic Agents for Urticaria and angioedema

A

Third-line treatment for chronic spontaneous urticaria is the addition of a leukotriene-receptor antagonist, cyclosporine A, or omalizumab,
Treatment of chronic urticaria with hydroxychloroquine, azathioprine, sulfasalazine, dapsone, colchicine, and intravenous immune globulin

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11
Q

Anaphylaxis

A

cute life-threatening clinical syndrome that occurs when large quantities of inflammatory mediators are rapidly released from mast cells and basophils after exposure to an allergen in a previously sensitized patient

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12
Q

Anaphylactoid

A

mimic anaphylaxis but are not mediated by IgE antibodies. They may be mediated by anaphylatoxins such as C3a or C5a or through nonimmune mast cell degranulating agents

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13
Q

S&S of Anaphylaxis

A

history is the most important tool
*Acute onset of an illness (minutes to several hours) with involvement of the skin, mucosal tissue, or both with either resp compromise or decreased blood pressure
*Two or more of the following that occur rapidly after exposure to a likely allergen for that patient- skin mucosal tissue involvement, respiratory compromise, reduced blood pressure, gastrointestinal symptoms
*Reduced blood pressure after exposure to a known allergen for that patient

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14
Q

Lab findings in anaphylaxis

A

absence does not rule out, tryptase released by mast cells can be measured within 3 hours of onset but can be normal
Electrocardiographic abnormalities may include ST-wave depression, bundle branch block, and various arrhythmias. Arterial blood gases may show hypoxemia, hypercapnia, and acidosis. The chest radiograph may show hyperinflation.

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15
Q

Prevention of anaphylaxis

A

Strict avoidance of the causative agent is extremely important, and effort to determine its cause should be made, beginning with a thorough history
carry epinephrine for self-administration
carry an oral antihistamine such as diphenhydramine or cetirizine, preferably in liquid or chewable preparation to hasten absorption

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16
Q

Treatment of anaphylaxis

A

antihistamines- diphenhydramine or cetirizine for younger patient along with ranitidine- h2 blocker
Fluids- persistent hypotension
Bronchodilators
Corticosteroids
Vasopressors
Observations
Can be fatal

17
Q

Adverse Reactions to drugs

A

undesirable and unintended response elicited by a drug
Allergic or hypersensitivity drug reactions are adverse reactions involving immune mechanisms

18
Q

Antibiotic drug reactions

A

Amoxicillin, trimethoprim–­sulfamethoxazole, and ampicillin are the most common causes of cutaneous drug reactions

19
Q

Penicillin and other b-lactam antibiotics

A

share a common β-lactam ring structure and a marked propensity to couple to carrier proteins, the R-side chains of the penicillins and cephalosporins have been implicated in most allergic reactions to these medications

20
Q

Sulfonamide reactions

A

reactive metabolite (hydroxylamine) produced by cytochrome P-450 oxidative metabolism

21
Q

Type of reactions

A

type I (IgE-mediated) reactions,
type II (cytotoxic) reactions such as drug-induced hemolytic anemia or thrombocytopenia,
type III (immune complex) reactions such as serum sickness,
type IV (T-cell–mediated) reactions such as allergic contact dermatitis