What to do with an allergic swelling
It is believed that allergic diseases, withwhose immune response is accompanied by damage to their own tissues, cover an average of about 10% of the world's population. Let's consider more in detail what it is and what to do with allergic reactions.
What are the types of allergic reactions?
Types of allergic reactions are different in severity. The severity of the course of allergic reactions can be divided as follows:
- mild and moderate - itching, hives, allergic rhinitis, hay fever, Quincke's edema;
- severe - anaphylactic shock.
Patients with an allergic reaction of immediatetype (anaphylaxis, atopic bronchial asthma, urticaria, Quincke's edema, hay fever, allergic rhinitis) often need urgent help. With such pathology, foreign substances (antigens) stimulate lymphocytes, which turn into plasma cells, that is, cells that produce antibodies. Antibodies are fixed on the surface of mast cells, which become sensitized. When the antigen enters the body again on the surface of mast cells, its interaction with the antibody takes place, this leads to the destruction (degranulation) of mast cells and the release of biologically active substances - mediators of allergy (histamine, serotonin, prostaglandins, etc.).
Anaphylactic shock - the most formidable clinical option acutean allergic reaction is most often observed after the administration of penicillin, but it can also occur after the use of other antibiotics, sulfonamides, therapeutic sera, radiocontrast agents, etc., and after insect bites.
Immediately after injection (or after 20-40 min)a feeling of tightness in the chest, dizziness, headache, anxiety, agitation or depression, severe weakness, a feeling of heat in the body, skin rashes and itching, rhinorrhea. At the same time there are suffocation, dry coughing, caused by the development of bronchospasm or swelling of the larynx with the stridor breathing.
In severe cases with allergic reactionsexpressed symptoms of shock: pallor and marble skin color, acrocyanosis; limbs become cold, the pulse is threadlike or not probed, the blood pressure falls or is not determined. With anaphylactic shock, the fall in blood pressure can be combined with the development of a coma. Seizures with the separation of foam from the mouth, involuntary urination - a consequence of severe hypoxia of the brain. In such cases, death may occur in a few minutes after the onset of shock. In less severe cases, the symptoms of fainting are observed in patients, combined with a mild bronchospasm and a drop in blood pressure.
Edema Quincke - angioedema (local orcommon) skin, subcutaneous tissue, mucous membranes. Angioedema of the larynx is manifested by coughing, hoarseness of voice, suffocation, stridoroznym breath, death from asphyxia is possible; edema of the gastrointestinal tract is accompanied by intestinal colic, nausea, vomiting (the cause of diagnostic errors and unreasonable surgical interventions).
Hives - sudden surface damageparts of the skin with the formation of sharply outlined round blisters with raised erythematous scalloped margins and a pale center, accompanied by pronounced itching. Rash during allergic reactions can persist for 1 to 3 days, leaving no pigmentation.
Allergic rhinitis - edema of the nasal mucosa, the release of abundant watery mucous secretion, stuffy nose, burning sensation in the conjunctiva and pharynx, lacrimation.
Hay fever (hay fever) - seasonal allergic reaction to pollen of plants, manifested by acute conjunctivitis and rhinitis.
What to do in case of allergic reactions: emergency care
Emergency care for allergic reactions, inparticularly with anaphylactic shock, should be provided without delay. Subcutaneously or intramuscularly administered in a dose of 0.3-0.5 ml of a 0.1% solution of epinephrine, if necessary, injections are repeated every 20 minutes for an hour. Adrenaline causes narrowing of the vessels of the skin, abdominal organs, skeletal muscles, relaxes the musculature of the bronchi.
Correction of arterial hypotension and replenishmentthe volume of circulating blood is carried out by means of transfusion of saline and colloidal solutions (500-1000 ml). With the development of bronchospasm, there are shown euphyllin and inhalations of beta-adrenomimetics (salbutamol, alupent).
Simultaneously with allergic reactionsintravenously administered 125-250 mg of hydrocortisone or 60-150 mg of prednisolone. Steroid hormones do not have immediate effect, but prevent relapses of the reaction. Glucocorticoids inhibit the development of immune cells (lymphocytes, plasmocytes) and reduce the production of antibodies, prevent the degranulation of mast cells and the isolation of allergic mediators from them and have an effect opposite to the effects of mediators of allergy-reducing vascular permeability, increasing blood pressure, etc.
What to do with allergic reactions: drug therapy
Antihistamines - H1 -gistaminovye blockers - are competitive antagonists of histamine released from mast cells, and their affinity for H1 -gistamine receptors is much lower than inactually histamine. Therefore, antihistamines do not displace histamine that binds to receptors, they block not occupied or released histamine receptors. Accordingly, H1 -gistaminovye blockers are most effective for the prevention of allergic reactions, and in the case of an already developed reaction, they prevent reactions to the release of new portions of histamine. Thus, H1 -gistaminovye blockers are used forallergic reactions only as an additional means to reduce the duration and prevent recurrence of the reaction. Preferred for use in allergic reactions of drugs such as terfenadine, zirtek, astemizole, - modern highly active antihistamines with minimal side effects.
When providing emergency care to patients withAnaphylactic shock requires quickness and clarity in the performance of prescriptions. Therefore, in the treatment rooms of polyclinics, ambulances, nursing and feldsher stations, it is necessary to have appropriate sets of medications and disposable syringes and droppers. After providing emergency care, the patient must be hospitalized and observed in the hospital.
The principles of treatment of Quincke's edema are the same asanaphylactic shock. For allergic allergic reactions (urticaria, hay fever, allergic rhinitis), antihistamines are prescribed and ketotifen is a drug that suppresses the release of biologically active substances (histamine, leukotrienes, slow-acting anaphylaxis substance).
© Author: therapist Elena Dmitrenko
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