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What trigger allergic/hypersensitivity reaction?

Complete antigen (large molecule)


Incomplete antigen (small molecule like Haptens) which combine with body protein

Target of allergies

Skin


Respiratory tract


GI tract


Blood
Blood vessels

Anaphylactic

Binding of allergen with specific antibody on mast cell

Anaphylactic reaction

1. antigen trigger production of IgE by B cell.


2. IgE bind to the surface of mast cell.


3. antigen brides the gap between two antibody molecules, degradation of the cell.


4. histamine/other mediators released.


5. permeability and distension of blood capillaries increase by histamine.

List of mediator release

Histamine


Leukotrienes


Prostaglandins


Bradykinin

Major site of histamine release

Mast cells


concentrated in skin,lungs, GIT

Allergen causes asthma act on

respiratory tract



Asthma characterized by

Chest tightness


Wheezing


Shortness of breath


Coughing


Recurrent reversible obstruction of the airways


Constriction of smooth muscle airways

What trigger asthma

Smokes


Vigorous activites


Ticks + Dust

Biphasic attack

Symptoms of an anaphylactic reaction can return anywhere from 1 to 72 hours after the first attack.

Immediate biphasic attack cause

Spasm ( involuntary contraction of muscle ) of smooth muscle

Late biphasic attack phase cause

acute inflammatory reaction

Treatment for asthma

Relievers


Preventers


Symptom controllers

Relievers contains

short acting beta agonist


Eg:


orciprenaline (alupent )


Terbutaline (bricanyl)

Symptom controller contains

long acting beta agonists


Eg:


Salmeteron (Serevent)



Preventers contains

Steroids and leukotriene antagonist

Allergic rhinitis can characterized into two which is

seasonal allergic rhinitis


perennial allergic



Allergens of allergic rhinitis act on

Nasal mucosa

Treatment for allergic rhinitis

Antihistamine (H1, antagonists)


Terfenadine


Fexofenadine


Loratadine


Cetirizine




Steroids

Urticaria also call as

Hives

Allergens for urticaria act on

Skin ( upper dermis )

Urticaria triggered by

allergens (milk,cheeses,egg)


drugs


synthetic products ( deodorant )


emotional factors ( stress )

Treatment for urticaria

allergen avoidance


antihistamines

Predictable adverse drug reactions are

dose dependent


effect dependent on pharmacology of drug


steep dose-response curve/narrow therapeutic

Non-predictable adverse drug reactions

not dose dependent


allergic requires prior exposure

Classification of Hypersensitivity Reaction

1. type I reaction (anaphylaxis, immediate hypersensitivity)


2. type II reaction (cytotoxic reactions)


3. type III reaction (immune complex reaction)


4. type IV reaction (cell mediated or delayed hypersensitivity reactions)

What is an idiosyncratic reaction?

Abnormal susceptibility to drug/protein to the individual