Anaphylaxis shock


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Anaphylaxis shock

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Anaphylaxis shock

  1. 1. Written by student dentist Tal Kaplan
  2. 2.  Notion Anaphylaxis shock  Classification's  Types of hypersensitivity reaction's  Etiology  Pathophysiology  Singe’s & Symptom’s  Diagnosis  First aid  Treatment  Prevention
  3. 3. The term derived from greek language ana – (without) , phylaxis – (protection). A sudden, severe allergic reaction characterized by a sharp drop in blood pressure, urticaria (skin rash), and breathing difficulties that is caused by exposure to a foreign substance, such as a drug or bee venom, after a preliminary or sensitizing exposure. The reaction may be fatal if emergency treatment is not achieved immediately, treatment including epinephrine injections. Also called anaphylactic shock.
  4. 4. By the Type of shock: • Typical • Cardiac • Asthmatic • Cerebral • Abdominal By type of development: • Momentry • Easy • Medium • Grave
  5. 5. Mast cell release histamine and other mediators Immediate hypersensitivity Antibodies directed against cell or tissue antigens Antibody- mediated Antibody- antigen complex deposit in blood vessels immune complex diseases Reactions of T lymphocytes T cell-mediated diseases
  6. 6. Idiopathic 37% Food 34% Drugs 20% Exercise 7% Latex, hormons, insect bites 2%
  7. 7. Pharmlogic agents •Antibiotics (penicillin) •Nonsteroidal anti- inflammatory drugs (Asprin) •intravenous (IV) contrast agents Stinging insects •Ants, bees, hornets, wasps, and yellow jackets. Food • Peanuts, seafood, and wheat Latex •Rare •No latex- associated deaths
  8. 8.  First exposure  Activation of TH2 cell → Stimulate IgE switiching Allergen TH2 Cell B Cell
  9. 9.  First exposure  IgE production IgE secreting B cell IgE
  10. 10.  First exposure  IgE bind to mast cell
  11. 11.  Second exposure  Recognition Allergen
  12. 12.  Second exposure  Activation of mast cell to release histamine and other mediators Mediators Allergen
  13. 13. • Typical type: Dizziness weakness fainting rapid, slow, or irregular heart rate low blood pressure Nausea vomitingcramps Itcing swlling around the eyesItching flushinghives swelling
  14. 14. • Respiratory type: Difficulty breathing coughing chest tightness wheezing or other sounds increased mucus production throat swelling or itching change in voice or a sensation of choking
  15. 15. • Cardiac type: Dizziness weakness fainting rapid, slow, or irregular heart rate low blood pressure
  16. 16. • Abdominal type: Nausea vomiting cramps diarrhea
  17. 17. The diagnosis of anaphylaxis is based upon symptoms that occur suddenly after being exposed to a potential trigger. Usually in dental clinic it will be more hard to get conclusive diagnosis. Differential diagnosis: • severe asthma attack • heart attack • panic attack • food poisoning - Those differential diagnosis are very similar to anaphylaxis shock and a doctor could get a wrong diagnosis due to lack of tools in reach to doctor hand. - An increased amount of tryptase protein can be measured in a blood sample collected during the first three hours after anaphylaxis symptoms have begun. - Tryptase levels are seldom elevated in food-induced anaphylaxis
  18. 18. Place patient in horizontal with legs up position. Establish and maintain airway. Give oxygen via nasal airway as needed. Place a tourniquet above the reaction site. Epinephrine at the site of antigen injection. Start IV to rise BP.
  19. 19. • Adrenalina sol. – 0.1% 0.5 ml, if patient state doesn't improve in 10-15 min, we Introduce 1.0 ml more of sol. • Suprastine sol. – 2% 1ml. • Prednisolone sol. 30-60 mg (unique dose) or hydrocortisone 75-125 mg. • Caffeine sol. Or cordiamine, or corazoli – 20% 1-2 ml. • In case of bronchospasm: eupheline sol. – 2.4% 5-10 ml or galidore sol. – 2ml (i/m). • To maintain cardiac activity are given cardiac glycosides & diuretics: lazex sol. – 2-4 ml (i/v), Corglicon sol. – 0.06% 0.5-1 ml (i/v). • In case of cardiovascular insufficiency: strophantini sol. 0.05% 0.5-1 ml, mazatoni sol. 0.1% 1m • Ionic sol. of NaCl 0.9% 400 ml or glucose sol. 5-10% 400 ml, in perfusion introduced dopamin sol. 200 gr or noradrenaline 0.1% 1ml. • Injection place should be infiltrated with adrenalin sol. • Artificial respiration with extern massage of the heart.
  20. 20. Avoid the responsible allergen (e.g. food, drug, latex, etc.). Keep an adrenaline kit (e.g. Epipen) and Benadryl on hand at all times. Wear medic Alert bracelets . Venom immunotherapy is highly effective in protecting insect-allergic individuals.