Inflammation 3

signs and symptoms in airway anaphylaxis

- coughing

- shortness of breath

- wheezing

- chest pain

- tightnessterm-30

- tightening of throat

- difficulty swallowing

allergy symptoms

- rash

- lacrimation

- runny nose

- sneezing

- rey eyes

- itching

allergens

trigger allergies

local allergy

contact dermatitis

treatment of contact dermatitis

topical antihistamine

topical antihistamine

Benadryl cream

Benadryl

diphenhydramine

systemic allergy

antihistamine non-drowsy preferred

antihistamine fro systemic exposure

reactin

reactin

cetirizine

reactin administration

1 tablet qd

eye symptoms tx

antihistamine topical to eye

antihistamine topical to eye

patanol eye drops

patanol

olopatadine

allergen exposure anticipated in high doses

prophylaxis with leukotrienet modifiers

drug (pretreatment)

Singulair

Singulair

montelukast

Singulair administration

1 tablet 2 days pre-exposure

systemic allergic response

anaphylaxis

signs and symptoms of anaphylaxis

- bronchoconstriction

- hypotension

bronchoconstriction

- massive inflammatory response

- mucus formed

hypotension

vasodilation

treatment of anaphylaxis focus

the ABCS

- airways

- breathing

- circulation

anaphylaxis drugs

- epinephrine

- dexamethasone

- antihistamines

epinephrine administration

intramuscular

intravenous

dexamethasone administration

intravenous

adjunct with dexamethasone

glucocorticoid to decrease inflammation

antihistamine administration

intravenous

IV fluids

for cardiac output and helps BP to have enough for CO

signs and symptom of anyaphylaxis areas

- airway

- skin

- brain

- heart

- stomach

signs and symptoms in skin anaphylaxis

- hives

- swelling

- itchiness

- widespread redness

- warmth

signs and symptoms in brain anaphylaxis

- anxiety

- confusion

- headache

- feeling that something is about to happen

signs and symptoms of heart anaphylaxis

- faint

- pale or blue color

- dizziness

- weak pulse

- shock

- loss of consciousness

signs and symptoms of stomach anaphylaxis

- nausea

- vomiting

- diarrhea

- stomach pain or cramps

epinephrine endogenous neurotransmitter and hormone

is non-selective adrenergic agonist (alpha, beta)

- antihistamine

epinephrine drugs

epipen, adrenalin

route of epinephrine administration

Intravenous and intramuscular

onset of epinephrine

rapid

duration of epinephrine

20 minutes needs repeat doses

glucocorticoid side effects

none or minimal side effects

acute treatment

anaphylaxis

examples of local treatment

topical voltaren PRN

intranasal avamys PRN

PRN

as needed

what increases risk of systemic effects

- systemic route (PO)

- long term treatment

negative feedback with glucocorticoids

treatment with glucocorticoids decreases/strop adrenal glucocorticoid synthesis

stopping glucocorticoid treatment

no abrupt stoppage of treatment and slow titrating dose using "weaning protocol"

cause of Cushing's syndrome

over treatment with systemic glucocorticoids= exaggerated side effects leading to dysfunction of affected systems

diagnoses marked by inflammation that is longterm

- allergic rhinitis

- dermatitis

- psoriasis

- arthritis

- IBD

- asthma

- COPD

evaluation of treatments

- clinical efficacy

- risk vs benefit

- local vs systemic effect

- patient response

length of acute inflammation

less than 10 days

chronic inflammation occurence

after an acute inflammation

chronic inflammation progression

after acute inflammation is the followed by proliferation of

- lymphocytes

- fibroblasts

- endothelia cells

- collagen V

inflammation mediators and tissue growth factors

collagen V

scar formation

inflammatory mediators and tissue growth factors cause

- tissue destruction by repetitive inflammation

- scar tissue formation

scar tissue formation makes

- less vascular

- less flexible

- less strong

cycle causes cellular tissue changes

- dysfunction of the tissue

- susceptibility to unusual growth and altered cellular division due to proliferation

risks of long term inflammation

cell division can lead to tumours

neoplasms

tumors

allergic rhinitis incidence

- very high incidence

- up to 40% of population

trigger of allergic rhinitis

inhaled allergens/hypersensitivity

occurence of allergic rhinitis

often seasonal

examples of allergic rhinitis allergens

pollen, dust, dander

signs and symptoms of allergic rhinitis

nasal mucosa is chronically swollen

conjunctivitis location

eyes

conjunctivitis symptoms

sneezing, snoring, itching, headache from nasal sinus congestion

bloodwork of allergic rhinitis

high eosinophils

treatment of allergic rhinitis

antihistamines pre/during exposure taken orally

intranasal corticosteroids for nasal mucos inflammation

drugs intranasal

- fluticasone

- mometasone

- budenoside

fluticasone

Flonase, Avamys

mometasone

Nasonex

budenoside

Rhinocort

atopy

tendency to develop allergies/heightened immune response

dermatitis

eczema

atopic dermatitis

most common types of eczema

atopic dermatitis trigger

allergy triggered

autoimmune tendency

antibodies in atopic dermatitis

high IgE plasma

chronic inflammation of the skin

- pruritic

- lichenification

pruritic

itchy

lichenification

scar formation

risk with scar inflammation

risk of superinfection by bacteria/viral

treatment of atopic dermatitis

- moisturize

- topical glucocorticoids

- anthistamines

- antibiotics/antivirals if infection

psoriasis

chronic inflammatory skin disease

risk factors for psoriasis

- family history

- skin trauma

- climate

- stress

- medications

hyperkeratosis

keratin layer overgrows

chronic inflammation of the skin causes

- hyperkeratosis

- thinned stratum granulosum

- dilated dermal papillae

signs and symptoms of psoriasis

dry scaly skin patches on extensor surfaces that are often non=pruritic

pruritic

itchy

differentiation of eczema and psoriasis

eczema is itchy

treatment of psoriasis

glucocorticoids

- moisturizing cream

- UV light (DMARD)

DMARD

disease-modifying antirheumatic drug

effects of UV light

I creases turnover and healing (proliferation of disease is decreased and healthy tissues increased

skin

collagen 1

UV light therapy

- stimulates angiogenisis

- increased collagen 1 synthesis

- induction of cell proliferation and differentiation

- mitochondrial ATP production

- modulation of cytokines and growth factors

angiogenesis

formation of new blood vessels

arthritis

joint inflammation

RA

chronic systemic rheumatic disease

rheumatic

inflammatory; autoimmune

is RA an autoimmune disease

yes

risk factors for RA

- family history

- gender

- trigger

RA gender susceptibility

women are more susceptible due to increased hormone levels