Unit 11: Allergy and Immune Flashcards
Type 1 hypersensitivity rxn
Interaction between antigen and IgE antibody; cells release histamine, leukotrienes, and prostaglandins
–produces vasodilation and increased capillary permeability
Typically anaphylactic
Type 2 hypersensitivity rxn
Cytotoxic reactions; antibody reacts with antigenic component of a cell; activates killer T cells to aid in destruction of antigenic cell
Transfusion reactions
Type 3 hypersensitivity rxn
Immune complexes activate complement system–promotes release of polymorphonuclear cells that promote tissue permeability
SLE is example
Type 4 hypersensitivity rxn
Delayed hypersensitivity
Allergic dermatitis
Cutaneous reaction
Urticuria, pruritus, hives
Secondary to release of histamine–antihistamines are mainstay of treatment
First generation antihistamine
Sedating
Diphenhydramine, hydroxyzine, chlorpheniramine
Cross the bbb
Cause anticholinergic effects
2nd generation antihistamine
nonsedating
Loratadine + Fexofenadine
Anaphylaxis reaction
Angioedema, pruritus, urticaria, N/V, wheezing, smooth muscle contraction, vasodilation
Immediate treatment with epinephrine to increase BP and acts as an antagonist to histamine
Allergic rhinitis
Airway allergy due to antigens: pollen, dust mites, mold spores, enzymes, insects, etc.
Mediators released into nasal mucosa causing vasodilation, increased capillary permeability, increased mucous production, and stimulation of nerve endings
Intranasal antihistamines
Olopatadine + Azelastine
Nasal decongestants
Sympathomimetic amines chemically related to NE
Cause vasoconstriction–relief from nasal congestion
Topical intranasal decongestants
Phenylephrine, naphazoline, oxymetazoline, tetrahydrozoline
Rebound phenomenon can occur
Intranasal corticosteroids
Beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone
Most effective form of therapy for allergic rhinitis
intranasal cromolyn
Mast cell stabilizer preventing antigen induced degranulation, inhibiting release of histamine and other cytokines
Helpful only in preventing nasal symptoms
First line therapy for allergic rhinitis
Intranasal corticosteroids
Second line therapy for allergic rhinitis
Antihistamines/nasal decongestants
AIDS CD4 count
<200
Initial symptoms of HIV
Fever, swollen lymph nodes, sore throat, skin rash, muscle soreness, HA, N/V, diarrhea
Dx criteria for HIV
Presence of HIV RNA or p24 antigen in plasma or serum
Normal CD4 count
500-1600
Nucleoside reverse transcriptase inhibitors
Abacavir, didanosine, emtricitabine, lamivudine, stavudine, zidovudine
May cause lactic acidosis
Non nucleoside reverse transcriptase inhibitors
Delavirdine, efavirenz, etravirine, nevirapine, rilpivirine
May cause GI distress
Protease inhibitors
-avir
Potent virologic efficacy, durable effects, high barriers to resistance
Fusion inhibitors
Enfuvirtide only available agent
Integrase inhibitors
Dolutegravir, elvitegravir, rategravir
Recommended in combo with dual NRTI
Recommended treatment in previously untreated patients
2 NRTI’s + 3rd drug (either protease inhibitor or integrase inhibitor)
