anaphylaxis shock

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Anaphylaxis Shock Written by student dentist Tal Kaplan

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Anaphylaxis shock

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Page 1: Anaphylaxis shock

Anaphylaxis Shock

Written by student dentist Tal Kaplan

Page 2: Anaphylaxis shock

Content: Notion Anaphylaxis shock Classification's Types of hypersensitivity

reaction's Etiology Pathophysiology Singe’s & Symptom’s Diagnosis First aid Treatment Prevention

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Notion Anaphylaxis shockThe 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.

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Classification'sBy the Type of shock:

• Typical• Cardiac• Asthmatic• Cerebral• Abdominal

By type of development:

• Momentry• Easy• Medium• Grave

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Type's of hypersensetivity reaction’s

Mast cell release

histamine and other mediators

Immediate hypersensitivi

ty

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

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Etiology

Idiopathic 37%Food 34%Drugs 20%Exercise 7%Latex, hormons, insect bites 2%

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Etiology

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

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Pathophysiology First exposure Activation of TH2 cell → Stimulate IgE switiching

Allergen

TH2 Cell B Cell

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Pathophysiology

First exposure IgE production

IgE secreting B cell IgE

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First exposure IgE bind to mast cell

Pathophysiology

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Second exposure Recognition Allergen

Pathophysiology

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Second exposure Activation of mast cell to release

histamine and other mediators

Mediators

Allergen

Pathophysiology

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Symptom's & Sing's• Typical type:

Dizziness weakness fainting

rapid, slow, or irregular heart rate

low blood pressure

Nausea vomitingcramps

Itcing swlling around the eyesItching flushing hives (urticaria)

swelling

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Symptom's & Sing's• 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

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Symptom's & Sing's• Cardiac type:

Dizziness weakness fainting

rapid, slow, or irregular heart rate low blood pressure

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Symptom's & Sing's• Abdominal type:

Nausea vomiting

cramps diarrhea

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DiagnosisThe 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

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First aidPlace 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.

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Treatment

• 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% 1ml• Ionic sol. of NaCl 0.9% 400 ml or glucose sol. 5-10% 400 ml, in perfusion introduced dopaminsol. 200 gr or noradrenaline 0.1% 1ml.• Injection place should be infiltrated with adrenalin sol.• Artificial respiration with extern massage of the heart.

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Prevention

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.

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THANK YOU, STUDENT DENTIST TAL KAPLAN