Hypersensitivity reaction

Hypersensitivity Reactions Tuberculin reaction in the BCG-infected guinea-pig 

Since there is a close relationship between connective tissue disorders and auto-immune diseases on the one hand, and delayed hypersensitivity on the other, it has been suggested that delayed hypersensitivity reactions offer 

The technique described by Floersheim is as follows. Guinea-pigs are sensitized by the subcutaneous administration of BCG vaccine in Freund s complete adjuvant. An intradermal injection of tuberculin 4-8 weeks later, elicits a typical erythematous reaction which is evaluated by measuring the degree of infiltration, the area of erythema and its intensity 8 and 24 hours after the tuberculin injection. Drugs under test are given 30 minutes before and 8 hours after the tuberculin. 

In contradistinction to the various types of chemically-induced and anaphylactic arthritis which have been mentioned above, adjuvant arthritis appears to simulate closely the inflammatory reactions seen in rheumatoid arthritis in humans. Stoerk, Bielinski and Budzilovitch first reported the development of a chronic polyarthritis in rats, and this work was later elaborated by a number of other workers . The reaction seems to be a type of delayed hypersensitivity response , although recent work suggests that this may not be so.  

Several techniques have been used to produce the reaction, but basically the arthritic syndrome can be elicited by injecting killed mycobacteria in mineral oil into the plantar surface of the foot or intradermally into the tail. From the tenth day onwards the joints of one or all of the feet gradually become inflamed and are painful, particularly when pressure is applied other inflammatory lesions occur in the ears, tail and lungs. These reactions are present in a severe form up to about the thirtieth day, after which they begin to subside . The degree of inflammation can be assessed visually or by measuring the swelling with a micrometer. 

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Blood dyscrasias are quite uncommon, but if they occur may be serious enough to cause discontinuance of the therapy. Both topical and systemic adrninistration of sulfas can cause hypersensitivity reactions, such as urticaria, exfoHative dermatitis, photosensiti2ation, erythema nodosum, and in its most severe form, erythema multiformexudativum. (Stevens-Johnson syndrome). In general, however, use of sulfonamide therapy is considered relatively safe. 

Experimental methods for determining the potential of materials to produce hypersensitivity reactions by inhalation use procedures to detect hyperreactivity of the airways as demonstrated by marked changes in resistance to air flow, and the detection of antibodies in blood semm (93). 

The cephalosporins generally cause few side effects (80,132,219—221). Thrombophlebitis occurs as a result of intravenous administration of all cephalosporins. Hypersensitivity reactions related to the cephalosporins are the most common side effects observed, but these are less common than found with the penicillins. Clinically only about 5—10% of patients with allergic reactions to the penicillins manifest the same reactions to the cephalosporins, and data would contradict any tme cross-reactivity to cephalosporins in patients who have previously reacted to penicillin (80,132,219). 

Phenytoin s absorption is slow and variable yet almost complete absorption eventually occurs after po dosing. More than 90% of the dmg is bound to plasma protein. Peak plasma concentrations are achieved in 1.5—3 h. Therapeutic plasma concentrations are 10—20 lg/mL but using fixed po doses, steady-state levels are achieved in 7—10 days. Phenytoin is metabolized in the fiver to inactive metabolites. The plasma half-life is approximately 22 h. Phenytoin is excreted primarily in the urine as inactive metabolites and <5% as unchanged dmg. It is also eliminated in the feces and in breast milk (1,2). Prolonged po use of phenytoin may result in hirsutism, gingival hyperplasia, and hypersensitivity reactions evidenced by skin rashes, blood dyscrasias, etc... 

As is well known, the principal toxicity associated with penicillin therapy is the occurrence of hypersensitivity reactions. This and other aspects of pencillin toxicity have been recently reviewed 81MI51106). 

Allergy A hypersensitivity reaction of the human body due to a particular substance. 

Type IVb Reactions Delayed Type Hypersensitivity Reactions... 

The fate of the patient largely depends on the first 30 min of an anaphylactic shock reaction. Thus persons with a known history of hypersensitivity reactions towards bee or wasp poison should always carry an emergency set during the insect season (see below). 

A number of chimerized, humanized, and one human mAb have now been approved for therapeutic use in humans in the treatment of autoimmunity, malignancy, infection and cardiovascular disease (Table 1). Some of the currently licensed mAb will be discussed here. A much larger number of mAb are currently being evaluated in Phase I, II and III trials. In general, chimeric, humanized and human mAb are very well tolerated with few side effects. Chimeric or humanized mAb still have the potential to evoke host immune response to the variable domains or CDRs of the antibody so-called HACA (human anti-chimeric antibody) or HAHA (human anti-human antibody) responses, although these responses are uncommon. Short-lived and occasionally severe infusion-related acute hypersensitivity reactions such as fever, skin itching, shivering, respiratory compromise and low blood pressure sometimes occur-. Such effects may... 

As with all drugs, the specific side effects of the quinolones must be considered when they are chosen for treatment of bacterial infections [5]. Reactions of the gastrointestinal tract and the central neivous system are the most often observed adverse effects during therapy with quinolones. It should be underlined, however, that compared with many other antimicrobials, diarrhea is less frequently observed during quinolone treatment. Antibiotic-associated colitis has been observed rarely during quinolone therapy. Similarly, hypersensitivity reactions, as observed during therapy with penicillins and other (3-lactams, is less frequently caused by quinolones. Some other risks of quinolone therapy have been defined and must be considered if a drug from this class is chosen for treatment of bacterial infections. 

Type IV allergic reactions are cell-mediated hypersensitivity reactions which are characterized by the expansion of T lymphocytes specific for foreign substances exposed on cell surfaces. In type FVa allergic reactions, this results in the cell-mediated destruction of the cells, whereas in type FVb allergic reactions an... 

Discuss hypersensitivity reactions and pseudomembranous colitis as they relate to antibiotic therapy. 

Gossitis, stomatitis, gastritis, furry tongue, nausea, vomiting, diarrhea, rash, fever, pain at injection site, hypersensitivity reactions,... 

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 Treatment of minor hypersensitivity reactions may include administration of an antihistamine such as Benadryl (for a rash or itching). Major hypersensitivity reactions, such as bronchospasm, laryngospasm,... 

Nausea, vomiting, diarrhea, hypersensitivity reactions, nephrotoxicity, headache, hematologic reactions Same as cefaclor... 

The most common adverse reactions seen with administration of the cephalosporins are gastrointestinal disturbances, such as nausea, vomiting, and diarrhea Hypersensitivity (allergic) reactions may occur with administration of the cephalosporins and range from mild to life threatening. Mild hypersensitivity reactions include pruritus, urticaria, and skin rashes. More serious hypersensitivity reactions include S teveils-Johnson syndrome (fever, cough, muscular aches and... 

The nurse observes the patient closely for any adverse drug reactions, particularly signs and symptoms of a hypersensitivity reaction. It is important to report a... 

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. 

Bacterial or fungal superinfections and pseudomembranous colitis (see Chap. 7) may occur with the use of both of these drugs. The administration of any drug may result in a hypersensitivity reaction, which can... 

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