قراءة
عرض

ANAPHYLAXIS

Dr. Rami M. Adil Al Hayali

ALLERGIC DISEASES

Group of diseases that involve an IgE mediated mechanism of hypersensitivity (Type  or immediate hypersensitivity reaction )

PATHOGENESIS OF ALLERGIC DISEASES

Antigens bind membrane-bound IgE on mast cells  Mast cell degranulation  Release of vasoactive and inflammatory mediators  Vasodilatation, smooth muscle contraction, mucus hypersecretion

ALLERGIC DISEASES

Atopy: Excessive tendency to form IgE antibodies to otherwise harmless environmental substances.
Allergic disease: the clinical manifestation of this inappropriate IgE response, resulting from the release of mast cell mediators (degranulation)
Anaphylaxis: systemic allergic reaction due to widespread mast cell degranulation

ALLERGIC DISEASES

Allergic rhinitis
Allergic conjunctivitis
Atopic eczema
Asthma
Urticaria
Angioedema
Food poisoning
Anaphylaxis

ANAPHYLAXIS

Life threatening multisystemic clinical syndrome
Generalized release of mediators from mast cells and basophiles
IgE dependant (anaphylactic) and IgE independent (anaphylactoid)

ANAPHYLAXIS

Generalized release of mediators results in:
1- Generalized vasodilatation
2- Increase vascular permeability
3- Smooth muscle contraction (bronchospasm and intestinal colic)

ANAPHYLAXIS

Commonly responsible antigens:
Drugs : penicillin, cephalosporins
Insect venom : bees, wasps
Foods :peanuts, eggs, banana
Latex : medical gloves powder
Anaphylactoid reaction: aspirin, radiocontrast media, exercise
20 % unknown aetiology

CLINICAL FEATURES OF ANAPHYLAXIS

Anaphylaxis develops rapidly, usually reaching peak severity within 5-30 min.
Early symptoms include a sensation of warmth and itching especially in the palms and soles, axilla and groin, and a feeling of anxiety and panic.
These may progress into rash, oedema of the face and neck, and breathlessness
Collapse and loss of consciousness may follow

CLINICAL FEATURES OF ANAPHYLAXIS

Signs on Examination:Breathlessness with wheezing (due to bronchospasm) or strider (due to laryngeal oedema)Flushing and sweatingTachypnoea, tachycardia, and hypotension“ Shock” in 30% of cases (anaphylactic shock)Skin rash ( urticaria and angioedema)

Urticaria

erythematous (reddened), irregular, elevated patches of the skin; associated with intense itching

Angioedema
Localized non-pitting swelling of the submucosal or subcutaneous tissue

DIAGNOSIS

Diagnosis of anaphylaxis is made clinically
Measurement of acute and convalescent serum mast cell tryptase confirms the diagnosis in difficult cases

TREATMENT OF ANAPHYLAXIS

1. Assessment of airways:clear the airway from dentures and secretionsendotracheal intubation and oxygen therapy may be needed2. Adrenaline: (0.3 – 0.5 ml of 1:1000 sol.) IM &  agonist inhaler (salbutamol)3. IV fluids (normal saline)4. Antihistamines (chlorpheneramine)5. Corticosteroids (hydrocortisone)

ANAPHYLAXIS IN DENTAL CLINICS



رفعت المحاضرة من قبل: Ayado Al-Qaissy
المشاهدات: لقد قام 5 أعضاء و 41 زائراً بقراءة هذه المحاضرة






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