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Pharm Exam 3 > Immune 2 > Flashcards

Immune 2 Flashcards

(44 cards)

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1
Q

Type 1 rxn is mediated by what?

A

IgE

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2
Q

What does a type 1 rxn look like?

A

Immediate rxn of allergies or anaphylactic

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3
Q

Type 2 rxn are mediated by what?

A

IgM and IgG

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4
Q

Type 2 rxn are also referred to as what?

A

Type II (cytotoxic hypersensitivity)

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5
Q

Examples of type 2 hypersensitivity rxn?

A

Granulocytopenia
Thrombocytopenia
Hemolytic anemia

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6
Q

Type 3 rxn are mediated by what?

A

Mediated by the IgG class and somewhat by IgM

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7
Q

Type 3 rxn is also called?

A

Type III (immune complex hypersensitivity)

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8
Q

Examples of Type 3 rxn?

A

Systemic lupus (arthritis, nephritis, skin lesions)
Rheumatoid arthritis
Serum sickness (vasculitis, nephritis)
Farmers lung (alveolar inflammation)

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9
Q

Type 4 rxn is also known as?

A

Type IV (delayed-type hypersensitivity)

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10
Q

What initiates Type 4?

A

initiated by mononuclear leukocyte T cells and macrophages, not antibodies

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11
Q

When does Type 4 rxn appear

A

48-72 hrs later

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12
Q

What is an adverse drug rxn?

A

Predictable, unpredictable, or genetic

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13
Q

What are the steps for managing a drug hypersensitivity?

A
  1. determine the offending drug and discontinue it
  2. tx based on the type of rxn
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14
Q

What is the best tx for type 4?

A

Steroids

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15
Q

What is the best tx for type 3?

A

NSAIDs

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16
Q

What is the best tx of type 1?

A

Antihistamines, bronchodilators, or steroids

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17
Q

In which cases should immunotherapy and desensitization to drugs be considered?

A

When the pt needs the meds (should be done by a trained allergist) - PCN or insulin

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18
Q

Anaphylaxis is mediated by what?

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A

IgE-mediated type I immune response to antigens and allergens that the pt has been previously exposed to

19
Q

What is an anaphylactoid rxn?

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A

immediate systemic reaction that mimics anaphylaxis but is not IgE mediated (can occur on the first contact w/ the allergen)

20
Q

Tx of anaphylaxis steps

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A

Maintaining an adequate airway and BP are crucial - monitor VS
Administer adrenalin (epinephrine) 0.2-0.5 mL of a 1:1000 (wt/vol) dilution (0.2- 0.5 mg) intramuscularly
Repeat adrenalin dose every 10-15 minutes as needed for first hour
+/- fluids or vasopressors if hypotensive
+/- steroids or diphenhydramine

21
Q

What does epinephrine do to the airway?

Study These Flashcards
A

Potent alpha receptor which causes rapid vasoconstriction and bronchodilation

22
Q

Epinephrine SE

Study These Flashcards
A

Palpitations, V Fib, and dysrhythmias

23
Q

Pts on BB may have epinephrine resistance, how is this overcome when tx someone w/ anaphylaxis?

Study These Flashcards
A

require glucagon injection to counter resistance

24
Q

When tx a pt w/ a stinging insect rxn, what should be done about the stinger?

Study These Flashcards
A

Attempt to remove w/o squeezing it

25
What is the difference between a food intolerance and an allergy?
Intolerance - nonimmunologic, just an abnormal rxn Allergy - less common, is an immunologic rxn
26
What is oral allergy syndrome?
Type of food allergy - brief involving the mouth and throat
27
What is the best way to tx food allergies?
Avoidance Sx tx is helpful but does nothing to the immune response
28
Common causes of contact derm?
poison ivy, household cleaners, and topical antimicrobials, anesthetics, and antihistamines
29
How is contact derm mediated?
T-cell-mediated response
30
Tx of contact derm
Remove offending allergen. Apply wet compress of water, saline, or Domeboro solution if acute eruption is present. Topical application of a class 2 or class 3 corticosteroid cream is advised for a brief period of time not to exceed 2 weeks
31
Angioedema
episodic, asymmetric, nonpitting swelling of loose tissue, involving subcutaneous tissues, abdominal organs, and the upper airway
32
What are the types of angioedema?
Histamine-mediated (allergic) – type 1 Bradykinin-mediated (non-allergic) iatrogenic or hereditary
33
Tx of mild to moderate urticaria/ angioedema
Begin with non-sedating second-generation antihistamines such as fexofenadine (Allegra), loratadine (Claritin), or cetirizine (Zyrtec) Consider adding older, sedating first-generation antihistamines such as diphenhydramine (Benadryl), or chlorpheniramine (Chlortrimeton) if symptoms persist or night-time pruritus and lack of sleep are a problem
34
Tx of bradykinin mediated angioedema
Purified C1 inhibitor concentrate Fresh frozen plasma Icantibant
35
Which pts are at risk of developing anti-D antibodies?
Rhesus (Rh) D-negative women who are exposed to fetal D-positive red cells
36
What happens to the immunoglobulins injected in emergent situation such as the tx of rabies?
Within a few months, at most, the immunoglobulins of passive immunity are gone and the antigen forgotten
37
How long does active immunity take to amount?
Active immunization usually requires up to 2 weeks for immunity to become adequate
38
Live attenuated vax compared to dead vax?
more potent than inactivated
39
Live vax examples
Measles Mumps Varicella Rubella Herpes zoster Rotavirus Nasal influenza
40
When should live vax be given if a pt is also on immunoglobulin tx?
should not be given <2 weeks prior to immunoglobulin therapy or at least 3 months after immunoglobulin therapy
41
How long should a pt wait after stopping an antiviral to get vax w/ a live vax?
It is recommended that the patient wait 24-48 hours after cessation of antiviral treatment before receiving a live attenuated viral vaccine
42
Which pts should NOT be given live vax?
Pregnancy Immunosuppression by disease Immunosuppression by medication
43
Toxioid vaccine examples
tetanus, diphtheria, and pertussis
44
Who should not receive polysaccharide vaccines?
Kids

Pharm Exam 3 (7 decks)

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