Respiratory: Antihistamines, allergen immunotherapy and allergic emergencies Flashcards
Injections of which two antihistamines can be used as an adjunct to adrenaline in the emergency treatment of anaphylaxis and angioedema?
Chlorphenamine maleate or promethazine hydrochloride.
Which antihistamine is included as an anti-emetic in a preparation for migraine?
Buclizine
What are th non-sedating antihistamine options? (5)
- Acrivastine
- Bilastine.
- Cetirizine.
- Desloratadine (active metabolite of loratadine)
- Loratidine
An oral preparation of grass pollen extract is licensed for disease-modifying treatment of grass pollen-induced rhinitis and conjunctivitis. What is the name of the preparation?
Grazax
There exists a monoclonal antibody that binds to IgE which is used as an additional therapy in individuals with proven IgE-mediated sensitivity to inhlaed allergens whose symptoms cannot be controlled by what?
What is the antibody called?
Cannot be adequately controlled with high dose inhaled corticosteroid together with a long-acting beta2 agonist.
It is known as omalizumab.
What are the two indications of Omalizumab?
Omalizumab is a monoclonal antibody that binds to immunoglobulin E (IgE). It is used as additional therapy in individuals with proven IgE-mediated sensitivity to inhaled allergens, whose severe persistent allergic asthma cannot be controlled adequately with high dose inhaled corticosteroid together with a long-acting beta2 agonist.
Also can be used as add-on therapy for the treatment of chronic spontaneous urticaria in patients who have had an inadequate response to H1-antihistamine treatment.
Arachis oil is also known as
Peanut oil
What is Grazax?
An oral preparation of grass pollen extract (Grazax®) is also licensed for disease-modifying treatment of grass pollen-induced rhinitis and conjunctivitis.
What can be used as an add-on therapy for the treatment of chronic spontaneous urticaria in patients who have had an inadequate response to H1-antihistamine treatment?
Omalziumab, antibody for IgE
What are the medicinal products particularly associated with anaphylaxis?
Blood products Vaccines Hyposensitising (allergen) preparations. Antibacterials. Aspirin. NSAIDS. Neuromuscular blocking drugs.
Why is administering an intravenous corticosteroid such as hydrocortisone used in the initial management of anaphylaxis? Are it’s effects immediate?
Administering an intravenous corticosteroid such as hydrocortisone (preferably as sodium succinate) is of secondary value in the initial management of anaphylaxis because the onset of action is delayed for several hours, but should be given to prevent further deterioration in severely affected patients.
What five treatments may be involved with the management of anaphylaxis?
- Adrenaline for the physiological reversal of the immediate symptoms associated with hypersensitivity reactions.
- High-flow oxygen.
- Intravenous fluids.
- An antihistamine, such as chlorphenamine maleate, by slow intravenous injection or IM injection.
- IV corticosteroid such as hydrocortisone.
How is continuing respiratory deterioration managed in anaphylaxis?
It requires further treatment with bronchodilators including inhaled or intravenous salbutamol, inhaled ipratropium bromide, intravenous aminophylline or intravenous magnesium sulfate [unlicensed indication].
On discharge following a severe anaphylactic shock, patients should be considered for further treatment with what and for how long?
On discharge, patients should be considered for further treatment with an oral antihistamine and an oral corticosteroid for up to 3 days to reduce the risk of further reaction. Patients should be instructed to return to hospital if symptoms recur and to contact their general practitioner for follow-up.
Tranexamic acid and danazol can be used for short-term and long-term prophylaxis of hereditary angioedema. What type of use of these drugs is this?
Unlicensed use.
