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35 Cards in this Set
- Front
- Back
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what is latex?
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*natural rubber protein
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where is rubber protein obtained from?
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*tree in brazil
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what is the incidence in the general population?
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*b/w 1-6%
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73% of peds population w/these conditions exhibit latex allergy?
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*spina bifida
*myelomeningocele *meningocele *SC injury *congenital urinary tract |
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what is the incidence of latex allergies in healthcare workers?
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8 - 17%
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what is the incidence of latex allergies in anesthesia providers?
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15%
(dental students 10%) |
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what other allergies a/w latex allergies?
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*avocados
*kiwi *banana *fig *chestnut *hazelnut *sweet pepper *melon *pineapple *papaya |
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what can happen with exposure to latex gloves?
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sever hand dermatitis
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what else might trigger latex allergies?
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*seasonal rhinitis
*asthma |
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contact dermatitis is what kind of rxn?
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*type IV sensitivity
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what is the most severe rxn in latex allergies?
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*IgE mediated (type I)
*anaphylactic rxn |
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what happens in anaphylactic rxns?
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*B cells produce IgE Ab in response to initial exposure to an antigen
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what do the Ab do anaphylactic rxn?
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*bind to receptors on the surfaces of mast cells and basophils
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what happens to a reexposure to an antigen in anaphylactic rxn?
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*results in activation of effector cells and release of histamine, leukotrienes, prostaglandins, kinins
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what is an anaphylactoid rxn?
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*chemically mediated
*no previous sensitization *same clinical presentation as anaphylaxis |
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what are the agents that are implicated in anaphylactic rxn?
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*ABX (PCN, cephalosp, sulfona)
*LA (procaine) *insulin *latex |
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what agents produce an anaphylactoid rxn?
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*muscle relax (sux, atri, mevi, pan, vec, curare)
*opioids (fenta, MSO4, demerol) *hypnotics (propofol, thio, etom) *protamine *colloids *steroids *vanco *NSAIDS |
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what does histamine do in an allergic rxn?
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vasodilation
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what does prostaglandin do in an allergic rxn?
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*bronchoconstriction
*vasodilation |
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what does leukotrienes do in an allergic rxn?
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*edema
*vasodilation |
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what do proteoglycans do in an allergic rxn?
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*DIC
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what do proteases do in an allergic rxn?
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bronchoconstriction
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what is the hallmark manifestation in an anaphylaxis rxn during anesthesia?
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*hypotension
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what is the length of time after exposure to an allergen before s/s appear?
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10 to 290 minutes after exposure
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what are the CV signs of anaphylaxis?
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*dec BP
*tachycardia *arrhythmias *CV collapse *pulm HTN |
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what are some pulm signs of anaphylaxis?
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*inc RR
*laryngeal edema *bronchospasm *pulm edema *dec pulm compliance *difficult to ventilate *inc PAWP *resp failure |
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what are the CNS sign of anaphylaxis?
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*disorientation
*dizziness *loss of consciousness |
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what are the cutaneous signs of anaphylaxis?
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*inc skin temp
*urticaria *flushing *pruritis *periorbital edema |
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what are the GI signs of anaphylaxis?
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*N/V
*diarrhea *abd pain |
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what are the renal signs of anaphylaxis?
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*ATN
*dec renal output |
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what is the primary tx plan of anaphylaxis?
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*stop admin of antigen
*airway *100% O2 *d/c all anesth agents *Epi 5-10 mcg IVP for hypoten *epi 0.1-1mg IVP CV collapse |
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what is the secondary tx plan of anaphylaxis?
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*antihistamines 0.5-1mg/kg
*catecholamine infusions *aminophylline 5-6mg/kg over 20min (persistent bronchospasm) *corticorsteroids *NaHCO2 (0.5-1meq/kg) *airway eval prior to extubate |
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what happens to the pt after an anaphylactic crisis?
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*ICU for 24hrs
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how long can s/s of sver rxn occur?
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up to 32 hours
*hypotension *pulm HTN *bronchospasm *laryngeal obstruction |
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what blood tests are ordered following an anaphylactic crisis?
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*RAST test for IgE
*tryptase levels (serial test immed after exposure, 1hr & 6hr after exposure) |
