GROUP 4CASE #1
CHRIS MOORE, FAITH LEMMONS & KAYLA KARIMI
MARTHA
• 28 years old, female
• Began Amoxic illin/Clavulanate
for a Urinary Tract Infection
• 1 hour after dose, she began to
have an allergic reaction
S OAP
• A penic illi n allergy is noted in
her chart – the reaction was a
rash.
SYMPTOMS TIMELINE
1 hour
TOOK
AUGMENTIN
To t reat U ri n ary Tract
I n fecti on
SOAP
4 hours
SIGNS OF
ALLERGIC
REACTION
Faci al s welli n g an d
breat hing problems
ARRIVED AT
ER
WORSENING
SYMPTOMS
P aramed ics
administrator
ep i n ephrine en rou te
S evere faci al s welli n g
an d b reat h ing p rob lems
as s oci at ed wi t h li p s an d
t on gu e s welli n g
OBJECTIVES
01
DET ER MINE T H E CAUSE O F MAR T H A’S ANAP H Y LACT IC
EP ISO DE
02
UNDER ST AND T Y P E 1 H Y P ER SENSIT IVITY
R EACT IO NS
03
P R O VIDE MAR T H A WIT H T H E AP P R O P RIATE
INFO R MATION & R ESO UR CES T O T AKE ACT IO N
IF AN EVENT LIKE T H IS WER E T O H AP P EN AGAIN
ASSESSMENT
DIAGNOSIS
IMMUNOLOGIC REACTION
IMMUNE RESPONSE
SO A P
TYPE 1 HYPERSENSITIVITY
Excess production of the
IgE antibody. Reactions
between allergens & IgE
bound to mast cells &
basophils lead to a
heightened
inflammatory response.
TYPE 1 HYPERSENSITIVITY
Immediate-Phase:
• Occur within the humoral branch immunity
• Mediated by antibody or antigen complexes
• After contact with antigen – 5 to 30 minutes
Late-Phase:
Caused by the formation of T Helper cells
Cell-mediated branch of immunity
2 to 24 hours
AUGMENTIN
amoxicillin/clavulanate
Oral anti bacteri al
combination cons is ting
of the s emis ynthetic
antibiotic amoxicillin
and the β – l actamas e
inhibitor
MOA
Beta-lactam inhibitors bind to B-lactamase
enzyme & inactivates them By opening B-lactam ring
CHEMICAL SIMILARITY
Penicillin
• Crossover
Augmentin
EPINEPHRINE
Paramedi c Epi dos i ng:
Adul ts = 0.30 mg of
1:1,000
MOA
PATHWAY
PLAN
SOA P
TREATMENT
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
EPINEPHRINE
ANTIHISTAMINE
CORTICOSTEROID
ELISA:
measures IgE levels
ALTERNAIVES
• W hi c h drug clas s to take f or
b e t t e r re s ults
• B road-s pectrum antibiotics are
of t e n us e d as an alte rnativ e t o
pe nicillin
• C e f azolin (1 s t G e ne ration
C e phalosporin)
COUNCELING
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
Lorem ipsum dolor sit amet,
consectetur adipiscing elit.
Duis vulputate nulla at ante
rhoncus, vel efficitur felis
condimentum. Proin odio
odio.
AVOID PENICILLIN &
B-LACTAM ANTIBIOTICS
SKIN TESTING
CARRY EPI PEN
OUR TEAM
Everest
Cantu
Drew
Holloway
Remy
Marsh
Ceo Of Ingoude
Company
Ceo Of Ingoude
Company
Ceo Of Ingoude
Company
QUESTIONS
QUESTION 1
WHICH IMMUNOLOGICAL MECHANISM IS PRIMARILY
RESPONSIBLE FOR THE SYMPTOMS OBSERVED IN
TYPE I HYPERSENSITIVITY REACTIONS LIKE
MARTHA’S?
A) T -cell mediated cytotoxicity
B) Activation of the complement sy stem
C) IgE -mediated mast cell degr anulation
D) Formation of immune complexes
QUESTION 1
ANSWER
C) IgE -mediated mast cell degranulation
QUESTION 2
IN MANAGING ANAPHYLACTIC REACTIONS, WHY
IS EPINEPHRINE THE FIRST -LINE TREATMENT
INSTEAD OF ANTIHISTAMINES OR
CORTICOSTEROIDS?
A) It directly inhibits the production og IgE antibodies
B) It provides immediate relief to bronchoconstriction
and vasodilation
C) It has a longer lasting effect than other medications
D) It specifically targets and neutralizes allergens
QUESTION 2
ANSWER
B) I t pr ovides immediate r elief to
bronchoconstriction and v asodilation
QUESTION 3
WHICH FACTOR PRIMARILY CONTRIBUTES TO
THE RISK OF CROSS -REACTIVITY BETWEEN
PENICILLINS AND CEPHALOSPORINS?
A) Similarity in their antibacterial spectrum
B) The presence of a beta -lactam ring in both classes
of antibiotics
C) Identical routes of metabolism and excretion in the
body
D) Both are derived from the same microbial species
QUESTION 3
ANSWER
B) The presence of a beta – lactam ring in
both c lasses of antibiotics
QUESTION 4
CONSIDERING MARTHA’S SEVERE ALLERGIC
REACTION, WHICH OF THE FOLLOWING WOULD
BE A KEY CONSIDERATION FOR FUTURE
ANTIBIOTIC THERAPY?
A) Preference for antibiotics with similar mechanisms of
action to ensure effectiveness
B) Use of broad -spectrum antibiotics to prevent resistance
C) Selection of antibiotics not structurally related to
penicillins to avoid cross -reactivity
D) Administration of antibiotics in a controlled hospital
environment
QUESTION 4
ANSWER
C) Selection of antibiotics not structurally related to
penicillins to avoid cross -reactivity
REFERENCES
Modified from: Naranjo CA et al. A method for estimating the probability of adverse drug reactions. Cli
n Pharmacol Ther 1981; 30: 239245.
PHARMACOLOGICAL
Alternative medications
Lorem ipsum dolor sit
amet, consectetur
adipiscing elit. Duis
vulputate nulla at ante
rhoncus, vel efficitur
felis condimentum.
Proin odio odio.
PROJECT 1
Lorem ipsum dolor sit
amet, consectetur
adipiscing elit. Duis
vulputate nulla at ante
rhoncus, vel efficitur
felis condimentum.
Proin odio odio.
PROJECT 2
Lorem ipsum dolor sit
amet, consectetur
adipiscing elit. Duis
vulputate nulla at ante
rhoncus, vel efficitur
felis condimentum.
Proin odio odio.
PROJECT 3
How epi works – pros & cons
Pharmacological – class differences
Penicillin desensitization
Skin Testing logistics
Counseling
Score
Q4 explanation
References
Spell Check
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
