Type i and type ii hypersensitivity rayan al humaid
1.
2. • Describe how to manage patients with
hypersensitivity type I and type I reactions.
3. Hypersensitivity type I :-
• Foods like peanuts
• Insect stings like bees
• Vaccines
• Medications:
- Pénicillin
Hypersensitivity type II :-
• Medications:
- Sulphonamides
- Methyldopa
- Pénicilline.
• Blood products
4. Anaphylaxis:
• The most common organ systems involved include the
cutaneous, respiratory, cardiovascular, and gastrointestinal (GI)
systems.
Swelling of toughItchingGeneralized hives
Shorting of breath
5. Treatment of anaphylaxis:
1. Place patient in recumbent
position and elevate lower
extremities.
2. Monitor vital signs frequently
(every 2–5 minutes) and stay with
the patient.
3. Administer oxygen, usually 8–10
L/min; Maintain airway with
oropharyngeal airway device.
Discontinuation of the medication or agent
when possible.
6. Administer epinephrine (1 : 1,000 ) SC
or IM. 0.01 mL/kg up to a maximum of
0.2–0.5 mL
• It is physiological antidote
•Histamine release vasodilation severe hypotension antagonized by Epinephrine
• Histamine release bronchospasm antagonized by Epinephrine
7. Treat hypotension with IV fluids or colloid replacement,
and consider use of a vasopressor such as Dopamine.
stimulate D1 receptors in renal vessels, mesentry
vasodilatation, ↑renal blood flow
– useful in cardiogenic & hypovolemic shock
Stimulate β1 receptors in the heart +ve inotropic
and contractlity &
At higher concentration ▲α1-receptors▲Blood
pressure
8. Treat bronchospasm resistant to
epinephrine with:
Salbutamol: Selective β2
– Stimulates β2 receptors like those
located in bronchi Broncho-
dilatation. Mast cell stabilizer
(B2)
– Used in bronchial asthma by
inhalation or Orally, IM,IV.
9. Hydrocortisone, 5 mg/kg, or
approximately 250 mg IV
Anti-inflammatory and
Immunosuppressive Effects by: -
Inhibit PLA2 decreases Synthesis of
inflammatory mediators e.g. PGs.,
Ltrs.
Anti-shock effects: They increase
BP & COP in shock (e.g. septic &
anaphylactic shock).
10. H1-receptor blockers (Antihistamines)
e.g:Chlorpheniramine , Citrizine , Loratidine, Fexofenadine
Mechanism of action:
Competitive antagonist of histamine at H1.
Actions due to blocking of histamine at H1
1. They prevent broncho-constriction
2. ▼Contraction of intestinal & other SM
11. 1-Hemolytic anemia (loss of the red blood cells).
2-leukopenia (loss of the white blood cells)
3-Thrombocytopenia (loss of the platelets)
4-Aplastic anemia (loss of all the formed blood cells)
1-Hemolytic anemia (loss of the red blood cells).
2-leukopenia (loss of the white blood cells)
3-Thrombocytopenia (loss of the platelets)
4-Aplastic anemia (loss of all the formed blood cells)
12. 1. Drug-induced immune hemolytic anemia: 2. Drug-Induced Oxidative Hemolytic Anemia:
In both causes Removal of the offending agent and give supportive care
A. Glucocorticoids can be helpful.
B. C. Agents as the anti-CD20
monoclonal Ab .e.g. rituximab
C. Blood transfusion (in sever cases)
A. Antioxidants: vitamin E & oral
selenium.
B. B-thlassemia major: Blood
transfusion, desferrioxamine,
vitamin C, folic acid.
C. Sickle cell anemia: hydroxyurea;
(Hb F (to 20%) and Hb S)
which adheres to endothelium
and occlude BV
N.B. Rituximab use to decrease angiogenesis,
autoantibodies production, complement and T cell activity
13. 1. corticosteroids is recommend in severe
symptomatic cases.
2. In the case of heparin-induced
thrombocytopenia heparin use instead
argatroban or hirudin.
3. Platelet transfusion, is used if clinically
indicated.
Removal of the offending agent and give supportive care
14. Removal of the offending agent and give supportive care
Most cases of neutropenia resolve over time.
Appropriate hygiene practices are necessary.
1. Symptomatic treatment (e.g.,
antimicrobials for infections) .
2. Sargramostim and filgrastim
(Granulocyte-Macrophage Colony-Stimulating Factor)
which used mainly in patients with a
neutrophil < 100 cell / mm³
15. Removal of the offending agent
and give supportive care
The goals of treatment are to
1- improve peripheral blood
counts
2- limit need for transfusions
3- minimize risk for infections.
16. Differentiation
• Allogeneic hematopoietic stem cell
transplantation (HSCT) treatment choice in
Patients < 40 years. old.
• Immunosuppression For patients older than 40
years .e.g. Antithymocyte globulin (ATG)
+ cyclosporine
• Blood transfusion, if needed.deferoxamine may be
needed to prevent iron toxicity
17.
18. - Abbas Basic Immunology- 5th edition.
- Katzungs Basic & Clinical Pharmacology -13th edition.
-This presentation adapted from DR. Ahmad Mobashir lecture.
