The document discusses allergy and anaphylaxis, including definitions, immunology, testing, common allergens that cause anaphylaxis (food, insects, drugs), signs and management of anaphylaxis. It notes that anaphylaxis is a severe life-threatening reaction requiring immediate epinephrine injection. Common triggers are foods, insects and medications. It emphasizes the importance of patients at risk always carrying epinephrine autoinjectors and knowing how to use them properly.
For more information:
http://www.7activestudio.com
info@7activestudio.com
http://www.7activemedical.com/
info@7activemedical.com
http://www.sciencetuts.com/
Contact: +91- 9700061777,
040-64501777 / 65864777
7 Active Technology Solutions Pvt.Ltd. is an educational 3D digital content provider for K-12. We also customise the content as per your requirement for companies platform providers colleges etc . 7 Active driving force "The Joy of Happy Learning" -- is what makes difference from other digital content providers. We consider Student needs, Lecturer needs and College needs in designing the 3D & 2D Animated Video Lectures. We are carrying a huge 3D Digital Library ready to use.
Anaphylaxis Management: Problems with the Current Paradigm and the need for ...Michael Langan, M.D.
Michael Langan, MD
Geriatrician, MGH Senior Health
September 10, 2012
Epi-Port (cartridge housing, portable, fashionable, easy to use)
Epi-Pod (cartridge, removable, replaceable)
A new drug delivery system for treatment of anaphylactic shock
Twist, Turn, Push (TTP)
From concept to patent to market
1:30P.M.-2:30P.M.
Fox Hill Village Auditorium
Sponsored by the MGH Wellness Center
*************************
To watch my animated viedo on YouTube visit
http://www.youtube.com/watch?v=nVHDGWfQhSU
To download my animated presentation visit:
https://www.dropbox.com/s/bbtayufrn1clnvh/Anaphylaxis.pptx
An insect that has an elongated body and a segmented, curved tail tipped with a venomous stinger.
A sting can be fatal to a person who is allergic to it.
The toxicity of scorpion venom varies by species. A given species' venom may contain many chemicals, some toxic to insects, others toxic to mammals.
Scorpion species with smaller and more slender claws generally have more toxic venom.
Scorpion stings are much more dangerous for infants and small children.
For more information:
http://www.7activestudio.com
info@7activestudio.com
http://www.7activemedical.com/
info@7activemedical.com
http://www.sciencetuts.com/
Contact: +91- 9700061777,
040-64501777 / 65864777
7 Active Technology Solutions Pvt.Ltd. is an educational 3D digital content provider for K-12. We also customise the content as per your requirement for companies platform providers colleges etc . 7 Active driving force "The Joy of Happy Learning" -- is what makes difference from other digital content providers. We consider Student needs, Lecturer needs and College needs in designing the 3D & 2D Animated Video Lectures. We are carrying a huge 3D Digital Library ready to use.
Anaphylaxis Management: Problems with the Current Paradigm and the need for ...Michael Langan, M.D.
Michael Langan, MD
Geriatrician, MGH Senior Health
September 10, 2012
Epi-Port (cartridge housing, portable, fashionable, easy to use)
Epi-Pod (cartridge, removable, replaceable)
A new drug delivery system for treatment of anaphylactic shock
Twist, Turn, Push (TTP)
From concept to patent to market
1:30P.M.-2:30P.M.
Fox Hill Village Auditorium
Sponsored by the MGH Wellness Center
*************************
To watch my animated viedo on YouTube visit
http://www.youtube.com/watch?v=nVHDGWfQhSU
To download my animated presentation visit:
https://www.dropbox.com/s/bbtayufrn1clnvh/Anaphylaxis.pptx
An insect that has an elongated body and a segmented, curved tail tipped with a venomous stinger.
A sting can be fatal to a person who is allergic to it.
The toxicity of scorpion venom varies by species. A given species' venom may contain many chemicals, some toxic to insects, others toxic to mammals.
Scorpion species with smaller and more slender claws generally have more toxic venom.
Scorpion stings are much more dangerous for infants and small children.
Allergy in exodontia /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
dear reader
This Powerpoint Illustrates The Hypersensitivity Type-I Only
Actually This My First Project That I create And Upload,Hope You Find This Powerpoint Helpful Even 10% ^_^ Thanks In Advance
Rania Hadi
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Anaphylaxis lecture uihc pulm_grand_round_11_4_2016 Sangil Lee
This is a lecture given to pulm/critical care grand round on 11/4/2016. The lecture content is relevant for clinical practice for first half and some of translational science (research) for second half.
Allergies arise when immune system reacts to foreign body.
The immune system produces substances known as antibodies that protect us from unwanted invaders which could make us sick or cause an infection. When one comes into contact with the allergen, the response of the immune system can inflame skin, sinuses, airways or digestive system.
The severity of allergies varies from one person to another and can range from trivial irritation to a potentially life threatening emergency. While most allergies cannot be cured, a number of treatments can assist get rid of allergy symptoms
Allergy is the reaction reflected onto one’s body due to a foreign substance. Allergies in the body can be caused due to foods, drugs and inhalants. Testing for allergy is the most effective way to diagnose and manage the allergens that can lead to severe complications in future. To know more about the diagnosis and management of different kinds of allergies, you can visit an allergy test lab in Ahmedabad.
Food allergies are the adverse effects that affect the immune system when certain kinds of food are eaten. It usually affects kids more than adults but is more frequently being seen in adults as well.
2. • Definitions
• Basic immunology of allergy
• Testing for specific IgE
• Food allergy
• Insect allergy
• Drug allergy
• Anaphylaxis
• Management of anaphylaxis
3. Definitions (EAACI/WAO)
• Hypersensitivity is objective reproducible symptoms
or signs, initiated by exposure to a defined stimulus
that is tolerated by normal subjects
• Allergy is immune mediated hypersensitivity
• Allergens are antigens, usually proteins, that cause
allergy
• Atopy is a personal and/or familial tendency to
become sensitised (ie. produce IgE) in response to
normal exposure to allergens, with development of
asthma, rhinoconjunctivitis and eczema
4. • Anaphylaxis is a severe potentially life-threatening
systemic allergic reaction characterised by rapid
onset of life-threatening airway breathing of
circulatory problems, and is usually but not always
associated with skin or mucosal changes
13. Detection of specific IgE in serum
Principle
• Allergen in solid phase
• Patient serum containing
specific IgE
• Detection
ALLERGEN
Detection Ab
IgE
19. t = 15 min
Rye grass 8mm
Bermuda grass 7mm
Johnson grass 9mm
Bahia grass 9mm
Ragweed 6mm
D. pteronyssinus 10mm
D. farinae 8mm
Cat dander 6mm
Dog dander 5mm
Mould mix 4mm
Positive control 6mm
Negative control
20. Serum tryptase
Ref: Simons, Camargo. 2010; Yunginger, Squillace et al. 1989; Sampson, Menderson et al. 1992.
• Serum tryptase should be measured within 4 hours after anaphylaxis
• Serum tryptase is often normal after food anaphylaxis
3.9
23. Food allergy or food intolerance?
Food intolerance:
• does not involve the immune system
• does not result in IgE mediated reactions including anaphylaxis
• symptoms can sometimes resemble those of mild or moderate
food allergy
There is no reliable skin or blood test to diagnose food intolerances
Diagnosis of food allergy and risk of anaphylaxis should always be
medically confirmed
1.2
24. Food allergy
Whilst 90% of food allergic reactions are caused by allergic reactions to
these foods, any food can cause an allergic reaction
1.11
25. Food allergy is common
2.3
In Australia:
• Children < 1yr: 10%
• Children < 5 yrs: 4-8%
• Adults: up to 2%
26. Natural history of food allergy
• Peanut, tree nut, fish, sesame and shellfish allergies
usually persist
• Milk, egg, soy and wheat allergy commonly resolve
• 85% of young children in population based studies
outgrow their allergy to milk or egg by age 3-5 years
2.4ref: http://foodallergens.ifr.ac.uk Skripak, JACI 2007, Savage, JACI 2007.
27. Cause of Allergic ReactionPercent
Peanut 60% 0.190968 37
Tree nut 27% 0.087742 17
Fish 2% 0.005161 1
Milk 8% 0.025806 5
Shrimp 3% 2
62
0% 10% 20% 30% 40% 50% 60% 70%
Peanut
Tree nut
Fish
Milk
Shrimp
Percent of Cases
Cause of Fatal Anaphylaxis
Common causes of fatal food anaphylaxis
Ref: Pumphrey, Garland. 2007 2.8
Shrimp (prawn)
28. AATHP 28 August 2011
• Majority of food-allergic individuals need to eat >500 mg
• Significant minority reacts to lower amounts
*Lowest Observed Adverse Effect Levels (LOEALs)
• Touching or smelling the allergen may cause mild/moderate
reaction but unlikely to cause anaphylaxis
Ref: Pumphrey. 2004, http://foodallergens.ifr.ac.uk, VITAL, 2007. 2.9
Small amounts of food can trigger anaphylaxis in
some very sensitive individuals
31. • Occurs in response to physical exertion
• Symptoms only occur if exercise within few hours of eating
specific food/s
• Most common foods:
– Wheat, other grains and nuts in Western populations
– Wheat and shellfish in Asian populations
– Fruits, vegetables, seeds, legumes, various meats, cow’s milk
and egg
• Symptoms include extreme fatigue, warmth, flushing, pruritus
and urticaria progressing to anaphylaxis
• Diagnosis usually based on clinical history
• Avoid culprit food/s for at least 4-6 hours before exercise
Food dependent exercise induced anaphylaxis
1.11
32. Insect stings are a common trigger of
anaphylaxis
7.1
Common triggers:
• Honey Bees (most common)
• Paper wasps
• European Wasps (becoming more common)
• Australian Jack Jumper Ant stings
33. 7.2
Bites less commonly trigger anaphylaxis than
insect stings
Although bites are common in endemic areas, anaphylaxis
is rarely triggered by:
• Ticks
• Mosquitoes
• March Flies
34. Reactions
• Typical local reactions:
– Erythema and painful swelling (up to 5cm) that
develops within minutes and resolves within hours
• Large local reactions
– 10%
– 10cm
– Peak at 48 hours and resolve over 5 – 10 days
– Risk of systemic reactions 5 – 15%
– May be IgE mediated
• Anaphylaxis
36. • Anyone with insect venom
anaphylaxis should be referred to a
clinical immunology/allergy
specialist, even if no immunotherapy
to allergen currently exists
• Adrenaline autoinjector should be
prescribed for all patients with
anaphylaxis to insect venom;
consider alert bracelet
When to refer for immunotherapy – insect venom
allergy
36
37. Drug allergy allergy
Adverse reactions to drugs is a significant problem, however allergic reactions (IgE
mediated) are rare:
• Antibiotics
– Uncommon
– Testing is only available for a limited range of antibiotics
• General anaesthetics
– Rare
– Specialised testing required
• Local anaesthetics
– Rare
– Vasovagal reactions are common
• Vaccination
– Rare, occurs in approximately 1/250,000 doses
• NSAIDS
– The majority of reactions are not IgE mediated
– IgE mediated reactions to NSAID are characterised by urticaria, angioedema or
anaphylaxis
1.13Ref: Up-to-date, 2010
38. Anaphylaxis
• Anaphylaxis is a severe potentially life-
threatening systemic allergic reaction
characterised by rapid onset of life-
threatening airway breathing of circulatory
problems, and is usually but not always
associated with skin or mucosal changes
39. Triggers of anaphylaxis
Common
• Foods
• Insects
• Medications
Uncommon
• Latex
• Exercise (with or without food)
• Cold temperature
• Immunisation (rare)
• Unidentified (idiopathic)
1.6
42. Fatal anaphylaxis - associations
• Asthma
• Delayed or no administration of adrenaline
• Age:
– Teenagers and young adults (food allergy)
– Adults (insect and drug allergy)
• Upright posture during anaphylaxis
• Food allergic individuals eating away from home
• Initial misdiagnosis
• Systemic mastocytosis
Previous mild/moderate reactions may not rule out subsequent
severe or fatal reactions
Ref: Bock. 2010; Liew, Williamson, Tang. 2008; Bock. 2007; Pumphrey. 2003; Bock. 2001
2.7
43. Signs of anaphylaxis
• Difficult/noisy breathing
• Swelling of the tongue
• Swelling or tightness in throat
• Difficulty talking and/or hoarse voice
• Wheeze or persistent cough
• Persistent dizziness or collapse
• Pale and floppy (young children)
Mild or moderate signs and symptoms may not
always precede anaphylaxis
44. All individuals at risk of anaphylaxis should:
• Know what to do in an emergency
• Have an ASCIA Action Plan for Anaphylaxis completed by their
medical practitioner
• Carry an adrenaline autoinjector and know how to use it
Management of anaphylaxis anaphylaxis
1.5
45. Why is adrenaline effective?
• Inhibits the release of inflammatory mediators
• Reverses the physiological effect of mediators by:
– Reducing airway mucosal oedema
– Inducing bronchodilatation
– Inducing vasoconstriction (thus increasing HR & BP)
– Increasing strength of cardiac contraction
Lasts ~ 15-20 minutes; repeated doses may be needed
after 5 minutes if no response
Ref: Tole, Lieberman. 20074.4
46. There are two brands of adrenaline autoinjectors –
EpiPen® and Anapen®
• Junior devices (150µg) recommended for
children 10 to 20 kg (aged ~1-5 years)
• Higher dose devices (300µg) recommended for
children over 20 kg (aged over ~5 years) and
adults
EpiPen Jr Anapen Jr
Anapen
5.2
EpiPen
47. Orange needle end
Blue safety
release
Viewing window
EpiPen with orange needle end and blue safety release
Expiry date
Instructions on
how to use
(on other side)
5.5
• Available in Australia mid 2011
48. How to give EpiPen with orange needle end and blue safety
release
5.6
50. PBS supply of adrenaline autoinjectors in Australia
• Maximum of 2 (EpiPen or Anapen) for both children and adults
• Initial supply:
– When risk and clinical need has been assessed by, or in
consultation with a clinical immunologist, allergist,
paediatrician or respiratory physician
– After hospital or emergency department discharge for acute
allergic anaphylaxis treated by adrenaline
• Continuing supply for anticipated emergency treatment of acute
allergic reactions with anaphylaxis, where the patient has
previously been issued with an authority prescription for this
drug
5.14
51. Guidelines for prescribing an adrenaline autoinjector
Always recommended if…
•History of anaphylaxis (and continued risk)
•These patients should be referred to a clinical immunology/allergy
specialist
May be recommended if…
•History of a generalised allergic reaction and one or more risk
factors:
– Asthma
– Age (children >5 yrs, adolescents, young adults)
– Specific allergic triggers
– Co-morbidity (e.g. ischaemic heart disease)
– Geographical remoteness from emergency medical care
•These patients should be referred to a clinical immunology/allergy
specialist
5.15
52. Guidelines for prescribing an adrenaline autoinjector
Not normally recommended...
• Asthma with no history of anaphylaxis nor generalised allergic
reactions
• Positive allergy test without a history of clinical reactions
• Family history of anaphylaxis or allergy
• Bee stings
− local reactions only (children and adults)
− generalised rash only (children)
• These patients generally do not need referral to a clinical
immunology/allergy specialist
5.16