Allergies to Drugs, Environmental Substances, Foods and Metals

Common Allergies

• local anesthetics

• aspirin

• penicillin

• metals

• latex

Signs of allergy

Mild:

• Urticaria: itching, hives

Severe:

• Asphyxiation, dyspnea (caused by angiodema)

• Reduction of blood pressure

Types of Hypersensitivity Reactions

Type I (immediate)

• seconds to minutes after exposure

• hives, redness, itching

• anaphylactic shock

Types of Hypersensitivity Reactions

Type II (cytotoxis)

• leads to hemolytic anemia

Types of Hypersensitivity Reactions

Type III (arthus)

• urticarial skin lesions: penicillin or hep vaccine

Types of Hypersensitivity Reactions

Type IV (delayed)

latex allergy

LA reactions

• Esters: benzocain, tetracaine topical

• Amides (allergies rare)

Aspirin reactions

• More common in those w/ asthma: 15-19% w/ asthma have aspirin allergy

• symptoms: mild skin reactions, anaphylaxis

Penicillin

• the most allergenic drug

• symptoms: milk skin reactions to anaphylaxis

Barbiturates and Sedatives

may be used in dental offices for stress reduction

Narcotics and Codeine

prescribed for oral pain in combination with other drugs

Common side effects

Nausea and vomiting, GI complaints

Reducing dose will help alleviate

Signs of allergy

rash, hives, and itching

reducing dose does not alleviate allergy

Latex allergy prevention

• cover latex stethoscope tube with a barrier

• use vinyl/non latex gloves

• use latex-free injectable LA cartridges and polishing cups

• Mark “LATEX WARNING” in chart

Management of Anaphylactic shock

Symptoms: immediate onset of skin reactions, progression to respiratory and cardiovascular problems

Immediate injection of epinephrine

Call 911

Position pt upright and provide 100% oxygen

Follow up questions

1. describe your symptoms

2. did your symptoms occur immediatley or were they delayed?