Clinical 1 (Part A) > Anaphylaxis > Flashcards

Anaphylaxis Flashcards

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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?

Study These Flashcards
A

intramuscularly in the mid to outer part of thigh

23
Q

Describe the action and duration of epipens?

Study These Flashcards
A

rapid onset

short duration

24
Q

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

25
Why do we inject into the thigh?
-great blood supply
26
What is the dose for the adult epipen?
0.3mg/dose
27
What is the dose for the epipen jr?
0.15mg/dose
28
Are there any contraindications of epinephrine?
no absolute contraindications
29
What are a few common adverse effects of epinephrine?
- anxiety - tremors - pallor - tachycardia (increase HR)
30
What is the acronym for what to watch for when expecting an allergic rxn?
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
____ hives are present for less than 6 wks
acute
32
____ hives are recurrent with signs and symptoms recurring most days of the week, for six weeks or longer
chronic
33
Describe the appearance of hives
- smooth - can be elevated - discolored itchy!
34
What can cause hives?
- allergic rxns - infections - illnesses - exposure to sun, heat, cold, or water - exercise - stress - contact w chemicals - scratching the skin
35
Recommended treatment for acute urticaria?
oral anti-histamines
36
Describe general treatment of insect bites and stings (5)
- 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
Describe the 6 OTC treatment options for insect bites and stings
- topical corticosteroids - oral antihistamines - skin protectants - topical anesthetics - topical antihistamines - topical counterirritants
38
What is the difference between an anesthetic and an analgesic?
Anesthetic: induces insensitivity to pain Analgesic: relieves pain
39
What do counterirritants do?
-depress cutaneous receptors resulting in relief of itching and irritation due to anesthetic
40
Do topical anesthetics have a short or long duration?
short (between 15 and 45 mins)
41
List some examples of topical anesthetics
benzocaine lidocaine pramoxine
42
What risk do topical anesthetics pose?
hypersensitivity rxn and systemic absorption/toxicity
43
T or F: drugs ending in "caine" are less common to pose a hypersensitivity risk than drugs with a different ending
false | -more common
44
How do topical antihistamines work?
They cause an anesthetic effect by DEPRESSING CUTANEOUS RECEPTORS to relieve pain and itching
45
What is more effective usually: oral or topical anesthetics
oral
46
Give an example of a topical antihistamine
topical diphenhydramine (benadryl)
47
What do skin protectants do?
reduce inflammation and irritation
48
Give 2 examples of skin protectants
zinc oxide | calamine
49
What are the 2 oral treatments for insect bites and stings
- analgesics (pain relief) | - oral antihistamines (relief of itching, inflammation and pain)
50
Give examples of oral analgesics (4)
- acetaminophen - ASA - naproxen - ibuprofen
51
Antipruritic
anti-itch
52
explain how topical corticosteroids works
Produce antipruritic and anti-inflammatory actions that can prevent or suppress development of edema, capillary dilation, swelling and tenderness
53
Edema
fluid collection
54
Discuss the 5 monitoring parameters
- pain/fever - itching - swelling/redness - signs of infection - anaphylactic rxn
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