Ch 24 allergy

mast cell-mediated hypersensitivity reaction

allergy

overreaction of immune system and is most serious of ADRs

hypersensitivity

2 type of allergies we are most concerned with in dentistry and why

1) Type 1 (anaphylactic)- immediate reaction, most unexpected and life threatening

2) Type IV (delayed)- presents as contact dermatitis, we come into contact with many patients who have this

What has not been used since 1984 in the US

methyl-paraben

drugs in dentistry that pose potential allergens

antibiotics, analgesics, opioids, LA, antioxidant, parabens

management of patient with allergy to local anesthesia

1) refer for consult/testing

2) dental anesthesia without LA during txt

3) use an injectable histamine blocker with N20 instead of LA

common after allergic reaction to topical, can be serious if airway is involved

edema/swelling

dramatic, acute life-threatening allergic reaction leading to possible death: fatal cases involve respiratory and cardiac predominantly and early, called anaphylactic shock

generalized anaphylaxis

usual cause of death in anaphylactic shock

laryngeal edema (can be delayed hours to days)

major chemical mediator of anaphylaxis, produced and then stored in mast cells or basophils in the blood, causes capillary dilation and permeability—redness, itching, pain on skin

histamine

single most important drug in the management of all serious allergic reactions and airway edema, has ability to reverse histamine and has a rapid onset of

epinephrine

If someone has an allergic reaction and loses consciousness without any obvious signs of allergy, we should

administer o2 but not epinephrine, call 911 if they do not wake up within a minute