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what are the antibiotic allergic reactions important to dental personnel? 10
- penicillin
- sulfonamides
- vancomyicn
- amphotericing b
- cephalosporins
- nitrofuratoin
- ciprofloxacin
- tetracyclines
- streptomycin
- chloramphenicol
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azo and non azo dyes used in _____, parabens-preservatives used in ____ and sulfites used in ____ are causes fo rallergic reactions important to the dental personnel
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what are the five functions of the immune system?
- processing of antigens
- cellular recognition of antigens
- cellular repsonse to presentation of antigen
- celluar action against antigen
- eradication of antigen
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what is a foreign substance that triggers hypersensitivity reactions; cause an immunologic reaction resulting in allergic diseases
antigen
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what are the 5 types of immunoglobulins?
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what immunoglobulin is the most abundant, diffuses into tissues, can cross the placenta, facilitates pagocytosis by neutrophils, binds to mast cells and has four subclass..1,2,3,4
IgG
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what immunoglobulin is found in saliva, tears, nasal mucous and protects from proteolysis and serum, does not cross placenta and is the last immunoglobulin to appear in childhood?
IgA
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what immunoglobulin is a large molecule, confined to intravascular sapce, is the first immunoglobulind produced and is a good agglutinating antibody
IgM
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what immunotglobulin is very low in concentration, increased in parastic and atopic disease, binds to mast cells and basophils and is KETY ANTIBODY IN PATHOGENESIS of TYPE I hyerpsensitivity reactions
IgE
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what immunoglobulin is low in concentration and little importance?
IgD
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what type of hypersensitivity is realted to humoral system, mediated by IgE, immediate response.
type I
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what type of hypersensitivity usual allergens are dust, mites, pollens, animal dander, foods and drugs
type I
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what hypersensitivity is it when symptoms on occasion include anaphylaxis, hay fever, asthma, urticaria and angioedema
type I
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hwat % or the popluation is affected by type I hypersensitivity?
10
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what hypersensitivity is mediated by IgG and IgM antibodies and is a Cytotoxic hypersensitivity and the antibodies combine with host cells to recognized as a foreign antigen which binds to host cell membranes during induced hemolytic anemia or thrombocytopenia
type II
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what are some examples of type II hypersensitivity?
transfusion reactions from mismatched blood, rhesus incompatibility, good pasture's syndrome
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what type of hypersensitivity involves cellular immune system, mediated by T lymphocytes but doesn't involve antibodies
type IV
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what type of hypersensitivity is the delayed type?
type IV
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what are some examples of type IV hypersensitivity?
contact dermatitis, graft and transplant rejection, graft vs host reaction, drug hypersensitivity, autoimmune diseases, tuberculin skin test, poison ivy
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urticaria, swelling, skin rash, chest tightness, dyspnea, shortness of breath, rhinorrhea, conjunctivitis are all signs and symptoms of what?
allergic reaction
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_____ allergy examples are syncope after LA injection, nausea or vomiting after ingestion of codeine
mislabeled
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talkativenss, slurred speech, dizzienss, nausea, depression, euphoria, excitement, convulsions are all signs and symptoms of what?
toxic reaction to LA
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toxic reactions to LA usually result from what?
inadvertent intravenous injection of LA solution..ASPIRATE BABY!
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tachycardia, apprehension sweating and hyperactivity are all signs and symptoms of what?
vasoconstrictor reaction
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hyperventilation, vasovagal syncope (bardycardia, pallor, sweating) sympathetic stimulation (anxiety, tremor, tachycardia, hypertension) are all signs of what?
psychomotor response to LA injection
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what is the LA associated with the highest incidence of allergic reaction?
procaine
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when should a pt be referred to an allergist?
pt has had allergic reaction to LA but not sure what ingredient triggered allergy
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what test is done by the allergist?
provocative dose testing (PDT)
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what ROA is contraindicated for penicillins?
topical
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what is the preferred ROA for penicillins?
oral route
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what ROA of penicillins can cuase more serious reactions?
perenteral
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what should pts allergic to penicillin be given for oral infections?
erythromycin/clindamycin
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what should be given to pts allergic to penicillins for prophylaxist against infective endocarditis?
clindamycin
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what are drugs to avoid for pneicillin allergy? 4
- ampicilliln
- carbenicillin
- methicillin
- occasionally cephalosporins
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what shoudl not be used for pt with ulcers, gastritis, hemorrhagic disease (prolong prothrombin time/platelet function) or hiatal hernia?
aspirin
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what can provoke severe reactions in asthmatics?
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rubber gloves, rubber dam, blood pressure cuff and catheters often cause what type of reaction?
type IV
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handsoaps used by healthcare workers cause what type of reaction?
type IV
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dnetal amalgam, acrylic, composite resin, nickel, eugenol, rubber products, talcum powder, mouthwases and toothpastes can all cause what type of reaction?
type IV (contact stomatitis)
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uticarial swellings or angioneurotic edema are oral manifesations for what type of reaction?
type I
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what is given for a type I reaction?
antihistamines
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white erythematous or ulcerative lesions are oral manifestations what type of reaction?
hype III
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contact stomatitis is an oral manifestation of what type of reaction?
type IV
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a pt is in the chair and angioneutoric edema is noticed in the tongue, pharyngeal tissues or larynx what type of reaction is the pt having and what should be done?
- type I
- place in supine
- clear airway
- give oxygen
- call EMS
- give epi
- CPR
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_____ occurs within minutes effecting both the respiratory and circulatory sytem together and is fatal if not taken care of immediately
anaphylaxis
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itching of soft palate, nausea, vomiting, substernal pressure, shortness of breath, hyptension, pruritus, urticaria, laryngeal edema, bronchospasm, cardiac arrhythmias are all signs and symptoms of what?
anaphylaxis
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what is the first thing to be done with an anaphylaxis pt?
call ems
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what position should an anaphylaxis pt be in
supine
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what can be given to a pt with anaphylaxis
epi
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