Hypersensitivities immediate

Patient should be instructed to report any symptoms of hypersensitivity immediately (fever flu-like symptoms rash blisters on skin or in eyes, mouth, ears, nose, or genital areas swelling of eyelids, conjunctivitis, lymphadenopathy)... 

There are two main sensitization reactions-immedi-ate and delayed hypersensitivity. Immediate type hypersensitivity is the result of antibody-allergen interaction occurring in the skin the reaction that develops is known as allergic contact urticaria. Delayed type hypersensitivity is the result of cell-mediated immunity and is the most frequently reported side effect of topical drugs. Both epidermal and dermal cells play pivotal roles in irritation and sensitization. Keratinocytes... 

Allergic reactions to constituents of hair dyes are not uncommon and are generally due to delayed hypersensitivity. Immediate hypersensitivity reactions have been described, but they are rare and seldom life-threatening. 

HYPERSENSITIVITY, DELAYED DERMATITIS, CONTACT POISON IVY DERMATITIS HYPERSENSITIVITY, IMMEDIATE ANAPHYLAXIS ANGIONEUROTIC EDEMA ARTHUS PHENOMENON ASTHMA... 

Tier I Acute toxicity Oral, dermal, and inhalation Irritation — primary ocular, primary dermal Hypersensitivity immediate, nonimmediate Genotoxicity Cellular Immune Response. 

Asthma is an extremely complex condition characterized by variable and reversible airways obstmction combiaed with nonspecific bronchial hypersensitivity (1 3). The cause of asthma, which is not always readily diagnosed (4), remains unknown. Days, if not weeks, ate needed to document the spontaneous reversal of the airways obstmction ia some patients. Asthmatics experience both an immediate hypersensitivity response and a delayed late-phase reaction, each mediated by a different pathway. Chronic asthma has come to be viewed as an inflammatory disease (5). The late-phase reaction plays a key role ia iaduciag and maintaining the inflammatory state which ia turn is thought to iaduce the bronchial hyperresponsiveness (6). The airways obstmction results from both contraction of airways smooth muscle and excessive bronchial edema. Edema, a characteristic of inflammatory states, is accompanied, ia this case, by the formation of a viscous mucus which can completely block the small airways. 

Sensitizer A sensitizer is defined by OSHA as "a chemical that causes a substantial proportion of exposed people or animals to develop an allergic reaction in normal tissue after repeated exposure to the chemical." The condition of being sensitized to a chemical is also called chemical hypersensitivity. Certain chemicals have no immediate health effect. But if you are exposed to them several times, they can make you allergic or sensitive to other chemicals. A classic example is formaldehyde (HCHO). Typical reactions to sensitizers can include skin disorders such as eczema. When working with sensitizers, always use proper protective equipment such as gloves, respirators, etc. Once you are sensitized to a particular chemical, even minute amounts will cause symptoms. Sensitization is usually a lifelong effect. 

Anaphylactic shock, which is a severe form of hypersensitivity reaction, also can occur (see Chap. 1). Anaphylactic shock occurs more frequently after parenteral administration but can occur with oral use This reaction is likely to be immediate and severe in susceptible... 

The nurse should observe the patient closely for a hypersensitivity reaction, which may occur any time during therapy with the penicillins If it should occur, it is important to contact the primary health care provider immediately and withhold the drug until the patient is seen by the primary health care provider. 

Monitoring and Managing Adverse Drug Reactions The nurse observes the patient at frequent intervals, especially during the first 48 hours of therapy. It is important to report to the primary health care provider the occurrence of any adverse reaction before the next dose of the drug is due The nurse should report serious adverse reactions, such as a severe hypersensitivity reaction, respiratory difficulty, severe diarrhea, or a decided drop in blood pressure, to the primary health care provider immediately because a serious adverse reaction may require emergency intervention. 

Like the other anti-infectives, bacterial or fungal superinfections and pseudomembranous colitis (see Chap. 7) may occur with the use of these drags. The administration of the aminoglycosides may result in a hypersensitivity reaction, which can range from mild to severe and in some cases can be life threatening. Mild hypersensitivity reactions may only require discontinuing the drug, whereas the more serious reactions require immediate treatment. 

Promoting an Optimal Response to Therapy Monitoring each patient for response to drug therapy and for the appearance of adverse reactions is an integral part of promoting an optimal response to therapy. The nurse immediately reports serious adverse reactions, such as signs and symptoms of a hypersensitivity reaction or superinfection, respiratory difficulty, or a marked drop in blood pressure... 

BARBITURATES The barbiturates can produce a hypersensitivity rash. Should a skin rash occur, the nurse must notify the primary health care provider immediately because the primary health care provider may discontinue the drug. The nurse carefully examines all affected areas and provides an accurate description. If pruritus is present, the nurse keeps the patient s nails short, applies an antiseptic cream (if prescribed), and tells the patient to avoid the use of soap until the rash subsides. 

Remifentanil (Ultiva) is used for induction and maintenance of general anesthesia and for continued analgesia during the immediate postoperative period. This drug is used cautiously in patients witii a history of hypersensitivity to fentanyl. 

During the first 30 minutes of infusion of a fat solution, the nurse carefully observesthe patient for difficulty in breathing, headache, flushing, nausea, vomiting, or signs of a hypersensitivity reaction. If any of these reactions occur, the nurse dis-continuesthe inf us on and immediately notifies the primary health care provider. 

Chen W, Mempel M. Schober W, Behrendt H, Ring 50 J Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 2008 63 1418-1427. 

Tamagawa-Mineoka R, Katoh N, Kishimoto S Platelets play important roles in the late phase of the immediate hypersensitivity reaction. J Allergy Clin Immunol 2009 123 581-587, 587.el-9. 

Systemic anaphylaxis is the most dramatic and potentially fatal manifestation of immediate hypersensitivity, accounting for more than 500 deaths annually [ 1 ]. Despite these alarming findings, there is surprisingly limited interest and little information on how the cardiovascular system is involved in fatal and near-fatal allergic diseases. 

Radiocontrast media (RCM) are highly concentrated solutions of triiodinated benzene derivatives used for performing diagnosis and treatment of vascular disease and enhancement of radiographic contrast [1,2]. However, adverse reactions after RCM administration are common [3]. The frequency and mechanisms of hypersensitivity reactions differ between monomeric and dimeric as well as between ionic and non-ionic types of RCM. Mild immediate reactions have been reported to occur in 3.8-12.7% of patients receiving ionic monomeric RCM and in 0.7-3.1% of patients receiving non-ionic RCM [4-6]. Severe immediate adverse reactions to ionic RCM have been reported in 0.1-0.4% of intravenous procedures, while reactions to nonionic iodinated RCM are less frequent (0.02-0.04%) [4-7]. Fatal hypersensitivity... 

Table 1. Clinical manifestations of immediate and non-immediate hypersensitivity reactions to RCM... 

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