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35 Cards in this Set

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  • Back
what is latex?
*natural rubber protein
where is rubber protein obtained from?
*tree in brazil
what is the incidence in the general population?
*b/w 1-6%
73% of peds population w/these conditions exhibit latex allergy?
*spina bifida
*myelomeningocele
*meningocele
*SC injury
*congenital urinary tract
what is the incidence of latex allergies in healthcare workers?
8 - 17%
what is the incidence of latex allergies in anesthesia providers?
15%

(dental students 10%)
what other allergies a/w latex allergies?
*avocados
*kiwi
*banana
*fig
*chestnut
*hazelnut
*sweet pepper
*melon
*pineapple
*papaya
what can happen with exposure to latex gloves?
sever hand dermatitis
what else might trigger latex allergies?
*seasonal rhinitis
*asthma
contact dermatitis is what kind of rxn?
*type IV sensitivity
what is the most severe rxn in latex allergies?
*IgE mediated (type I)
*anaphylactic rxn
what happens in anaphylactic rxns?
*B cells produce IgE Ab in response to initial exposure to an antigen
what do the Ab do anaphylactic rxn?
*bind to receptors on the surfaces of mast cells and basophils
what happens to a reexposure to an antigen in anaphylactic rxn?
*results in activation of effector cells and release of histamine, leukotrienes, prostaglandins, kinins
what is an anaphylactoid rxn?
*chemically mediated
*no previous sensitization
*same clinical presentation as anaphylaxis
what are the agents that are implicated in anaphylactic rxn?
*ABX (PCN, cephalosp, sulfona)
*LA (procaine)
*insulin
*latex
what agents produce an anaphylactoid rxn?
*muscle relax (sux, atri, mevi, pan, vec, curare)
*opioids (fenta, MSO4, demerol)
*hypnotics (propofol, thio, etom)
*protamine
*colloids
*steroids
*vanco
*NSAIDS
what does histamine do in an allergic rxn?
vasodilation
what does prostaglandin do in an allergic rxn?
*bronchoconstriction
*vasodilation
what does leukotrienes do in an allergic rxn?
*edema
*vasodilation
what do proteoglycans do in an allergic rxn?
*DIC
what do proteases do in an allergic rxn?
bronchoconstriction
what is the hallmark manifestation in an anaphylaxis rxn during anesthesia?
*hypotension
what is the length of time after exposure to an allergen before s/s appear?
10 to 290 minutes after exposure
what are the CV signs of anaphylaxis?
*dec BP
*tachycardia
*arrhythmias
*CV collapse
*pulm HTN
what are some pulm signs of anaphylaxis?
*inc RR
*laryngeal edema
*bronchospasm
*pulm edema
*dec pulm compliance
*difficult to ventilate
*inc PAWP
*resp failure
what are the CNS sign of anaphylaxis?
*disorientation
*dizziness
*loss of consciousness
what are the cutaneous signs of anaphylaxis?
*inc skin temp
*urticaria
*flushing
*pruritis
*periorbital edema
what are the GI signs of anaphylaxis?
*N/V
*diarrhea
*abd pain
what are the renal signs of anaphylaxis?
*ATN
*dec renal output
what is the primary tx plan of anaphylaxis?
*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
what is the secondary tx plan of anaphylaxis?
*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
what happens to the pt after an anaphylactic crisis?
*ICU for 24hrs
how long can s/s of sver rxn occur?
up to 32 hours
*hypotension
*pulm HTN
*bronchospasm
*laryngeal obstruction
what blood tests are ordered following an anaphylactic crisis?
*RAST test for IgE
*tryptase levels (serial test immed after exposure, 1hr & 6hr after exposure)