1. ALLERGIC REACTIONS
Hypersensitivity/allergic responses- an increased or excessive response to the presence of an antigen to
which the client has been previously exposed
Type1: Rapid hypersensitivity reactions
- Reaction of IgE antibody on the mast cells with antigen, which results in the relase of mediators,
especially histamine
- Can be contacted in the following ways:
o Inhaled- plant pollen, fungal spores, animal dander, house dust, grass, ragweed)
o Infested- food, food additives, drugs
o Injected- bee venom, drugs, biologic substances such as dyes and adrenocorticotropic
hormone
- Contracted- pollens, foods, environmental proteins
Type 2: Cytotoxic- reaction of IgG with host cell membrane or antigen absorbed by host cell membrane
- Examples: Autoimmune hemolytic anemia
- Goodpasture’s syndrome
- Hemolytic transfusion reaction
Type 3: Immune complex-mediated
- Formation of immune complex of antigen and antibody, which results in complement release
and inflammation
- Examples: serum sickness, vasculitis, SLE, rheumatoid arthritis
Type 4: delayed hypersensitivity reactions
- Reaction of sensitized T-cells with antigen and release of lymphokines, which activate
macrophages and induce inflammation
- Examples: poison ivy, graft rejection, positive TB skin tests, sarcoidosis
Type 5: stimulatory reactions
- Reaction of autoantibodies with normal cell-surface receptors, which stimulates a continual
overreaction of the target cell
- Ex: Grave’s dse, B-cell Gammopathies
ALLERGIC DISORDERS

2. ANAPHYLAXIS- results from type1 in w/c release of chemical mediators from mast cells result in massive
vasodilation, increased capillary permeability
- Loss of consciousness, hives, swelling of tongues and throat tissues, inability to swallow,
difficulty breathing, low BP
- CxMx- uneasiness, apprehension, weakness, generalized itching, urticaria
- Intvns: tourniquet, CPR, O2, epinephrine, antihistamine, bronchodilators, steroids, strict IV
regulations
ALLERGIC RHINITIS- inflammation of the nasal mucosa caused by an allergen
- Dx: inc eosinophil in nasal smear
o Skin testing confirms hypersensitivity to specific allergen
o Radioallergosorbent test
- Mgt: antihistamines, topical or oral decongestants, intranasal cromolyn sodium, corticosteroids
intranasally or orally, immunotherapy
- Supportive care: reassure patient that suffocation will not occur
o Use bedside humidifier and inc fluid intake
o Observe pt after immunotherapy injection for 30mins for reaction
- Health maintenance- nasal inhalers, OTC decongestants to 2-3days only
DERMATITIS
Contact dermatitis- acute or chronic rash caused by either direct contact with an irritant substance or by
contact with an allergen
ATOPIC DERMATITIS- chronic rash that occurs with respi allergies and atopic skin dse
DERMATITIS MEDICAMENTOSA- drug reactions
Mgt: avoidance therapy, steroids
- Avoid applying oil-based products to sweaty skin folds; favourably used
- Corticosteroids never cure
- Antihistamines
- Compresses and baths
- Colloidal oatmeal preparations, tar extracts, cornstarch or oils are often added to baths to
relieve itching
URTICARIA
SERUM SICKNESS
- Caused by a collection of immune complexes deposited in the skin, joints and kidney

3. - Less common now because vaccines are made with human protein
- Causative agents: antilymphocyte globulin
- Interventions: symptomatic tx, antihistamine, aspirin, prednisone
LATEX ALLERGY