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    Allergic Reactions and Anaphylaxis: Della Septa Dr. Donni Indra K, SP - An FAKV

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    Della Septa
    1) Anaphylaxis is a severe, life-threatening generalized or acute systemic hypersensitivity reaction. It is commonly graded 1-4 in severity. 2) Anaphylactic reactions are most often triggered by minute amounts of antigens like certain foods, drugs, or insect stings. The mechanisms involve IgE antibodies binding to mast cells and basophils. 3) Risk factors include age, physiological state, concomitant diseases, concurrent medications, and amplifying co-factors like exercise. Perioperative causes in the UK included antibiotics, neuromuscular blocking agents, and latex.

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    Allergic Reactions and Anaphylaxis: Della Septa Dr. Donni Indra K, SP - An FAKV

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    1) Anaphylaxis is a severe, life-threatening generalized or acute systemic hypersensitivity reaction. It is commonly graded 1-4 in severity. 2) Anaphylactic reactions are most often triggered by minute amounts of antigens like certain foods, drugs, or insect stings. The mechanisms involve IgE antibodies binding to mast cells and basophils. 3) Risk factors include age, physiological state, concomitant diseases, concurrent medications, and amplifying co-factors like exercise. Perioperative causes in the UK included antibiotics, neuromuscular blocking agents, and latex.

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    Anestesi

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    Syok Anafilaktik

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    1) Anaphylaxis is a severe, life-threatening generalized or acute systemic hypersensitivity reaction. It is commonly graded 1-4 in severity. 2) Anaphylactic reactions are most often triggered by minute amounts of antigens like certain foods, drugs, or insect stings. The mechanisms involve IgE antibodies binding to mast cells and basophils. 3) Risk factors include age, physiological state, concomitant diseases, concurrent medications, and amplifying co-factors like exercise. Perioperative causes in the UK included antibiotics, neuromuscular blocking agents, and latex.

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    33 views23 pages

    Allergic Reactions and Anaphylaxis: Della Septa Dr. Donni Indra K, SP - An FAKV

    Uploaded by

    Della Septa
    1) Anaphylaxis is a severe, life-threatening generalized or acute systemic hypersensitivity reaction. It is commonly graded 1-4 in severity. 2) Anaphylactic reactions are most often triggered by minute amounts of antigens like certain foods, drugs, or insect stings. The mechanisms involve IgE antibodies binding to mast cells and basophils. 3) Risk factors include age, physiological state, concomitant diseases, concurrent medications, and amplifying co-factors like exercise. Perioperative causes in the UK included antibiotics, neuromuscular blocking agents, and latex.

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    of 23

    ALLERGIC REACTIONS AND

    ANAPHYLAXIS

    Della Septa
    dr. Donni Indra K, Sp.An FAKV
    Fakultas Kedokteran Universitas Trisakti
    RSUD K.R.M.T Wongsonegoro
    Kepaniteraan Klinik Ilmu Anestesi
    Periode 23 September – 26 Oktober 2019
    ANAPHYLAXIS DEFINITION

    Anaphylaxis is defined as a severe, life-threatening


    generalized or acute systemic hypersensitivity
    reaction. Severity is commonly graded 1-4.

    2018 British Journal of Anaesthesia. Published by Elsevier Ltd.: Johansson SG, Hourihane JO, Bousquet J, et al. A revised
    nomenclature for allergy. An EEACI position statement from the EEACI nomenclature task force.
    ANAPHYLAXIS MECHANISM AND
    TRIGGERS

    Most anaphylactic reactions are triggered in some people by minute amounts of


    antigen (e.g. certain foods, drugs or single insect stings)
    ANAPHYLAXIS MECHANISM
    AND TRIGGERS

    Simons FER et al. World Allergy Organization Journal


    2014; 4:13 http://www.waojournal.org/content/4/2/13
    RISK FACTORS FOR
    ANAPHYLAXIS

    • Age
    • Physiologic state (such as pregnancy)
    • Concomitant diseases
    ― poorly controlled asthma
    ― cardiovascular disease
    • Concurrent use of medications
    ― Beta-adrenergic blockers
    ― ACE inhibitors
    • Amplifying co-factors
    ― exercise
    ― non-steroidal anti-inflammatory drugs
    CAUSES IN
    PERIOPERATIVE
    ANAPHYLAXIS
    The 6th National Audit Project (NAP6) on perioperative anaphylaxis collected and
    reviewed 266 reports over 1 yr from all NHS hospitals in the UK (2018)
    ANTIBODY-MEDIATED ANAPHYLAXIS
    PATOPHYSIOLOGY
    1. Ingestion, injection,
    mucosal contact 2. APC (mostly dendritic cells)
    present Ag to Th cells

    3.Th2 stimulates B cells


    to differentiate into
    plasma cells and
    product IgE 4. IgE binds to FcεRI
    receptors on mast cell
    CLINICAL FEATURES
    CLINICAL CRITERIA FOR THE
    DIAGNOSIS OF
    ANAPHYLAXIS
    Simons FER et al. World Allergy Organization Journal
    2014; 4:13 http://www.waojournal.org/content/4/2/13
    CLINICAL FEATURES ON
    PERIOPERATIVE ANAPHYLAXIS

    The 6th National Audit Project (NAP6) on perioperative anaphylaxis collected and reviewed 266 reports
    over 1 yr from all NHS hospitals in the UK (2018)
    ANAPHYLAXIS GRADING I-IV

    Ring J, Beyer K, Biedermann T, Bircher A, Duda D, Fischer J et al. Guideline for acute therapy and management of
    anaphylaxis. S2 guideline of DGAKI, AeDA, GPA, DAAU, BVKJ, ÖGAI, SGAI, DGAI, DGP, DGPM, AGATE and
    DAAB. Allergo J Int 2014; 23: 96–112
    EMERGENCY EQUIPMENTS
    BASIC MANAGEMENT OF
    ANAPHYLAXIS
    W O R L D A L L E R G Y O R G A N I Z AT I O N G U I D E L I N E S
    REGIMEN OF ACUTE ANAPHYLAXIS TREATMENT
    A L L E R G O J I N T 2 0 1 4 ; 2 3 : 9 6 − 11 2
    TREATMENT FOR ANAPHYLAXIS

    No Name of Drugs Mechanism of Acions


    1 Adrenaline Through the activation of α- and β-adrenergic
    receptors, adrenaline is functionally
    antagonises all of the important
    pathomechanisms of anaphylaxis by
    vasoconstriction, reduction of vascular
    permeability, bronchodilatation, edema
    reduction and positive inotropy in the heart.

    2 Noradrenaline Potent α und β1 adrenoceptor agonist and


    stimulates the β2- adrenoceptor to a lesser
    extent than adrenaline so that, at a therapeutic
    dose, the bronchodilatatory effect is lower.
    TREATMENT FOR ANAPHYLAXIS

    No Name of Drugs Mechanism of Acions


    3 Vasopressin In anaesthesiological literature, the application
    of vasopression for the treatment of severe
    hypotension
    4 Antihistamines H1 The efficacy of H1 antagonists in acute
    receptor antagonists urticaria or rhinoconjunctivitis are evident.
    Compared to adrenaline, antihistamines show a
    slower onset of action
    5 Glucocorticoids Due to their slow onset of action,
    glucocorticosteroids play a minor role in the
    acute phase of anaphylaxis treatment
    TREATMENT FOR ANAPHYLAXIS

    No Name of Drugs Mechanism of Acions


    6 Oxygen In case of manifest cardiovascular or pulmonary
    reactions, immediate supply of oxygen via an
    oxygen mask with reservoir bag, is recommended
    7 Volume Substitution An important pathophysiological aspect of
    anaphylaxis is the resulting hypovolemia which
    is treated with adequate volume substitution.
    • Primarily, normal saline (NaCl 0.9 %) or
    balanced electrolyte solutions should be used
    • HES (HES 6 % 200/0.5) are the most
    commonly used volume substitutes in
    anaphylactic shock.
    DOSES
    DIS CHARGE MANAGEMENT AND P REVE NT ION OF
    FUTURE ANAPHYL AXIS RECURRE NCES IN THE
    COMMUNITY

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