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Penicillin a group of antibiotics derived from Penicilllum fungi.

Penicillin a group of antibiotics derived from Penicilllum fungi. discovery is attributed to Alexander Fleming in 1928. one of the first drugs were effective against previously serious diseases such as TB, syphillis and staph infections. Classified under Beta Lactam antibiotics.

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Penicillin a group of antibiotics derived from Penicilllum fungi.

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  1. Penicillin • a group of antibiotics derived from Penicilllum fungi. • discovery is attributed to Alexander Fleming in 1928. • one of the first drugs were effective against previously serious diseases such as TB, syphillis and staph infections. • Classified under Beta Lactam antibiotics

  2. Anaphylaxis • is an acute systemic(multi-system) and severe type I hypersensitivity allergic reaction • The classic form involves prior sensitization to an allergen with later re-exposure, producing symptoms via an immunologic mechanism.

  3. Type I hypersensitivity Reaction

  4. Anaphylaxis • It results from cross-linking of membrane-bound IgE on blood basophils or tissue mast cells by antigen. This cross-linking causes cells to degranulate, releasing substances such as histamine, leukotrienes, and eosinophilchemotactic factor which cause the symptoms

  5. Signs Symptoms Abdominal pain or cramping Abnormal (high-pitched) breathing sounds Anxiety Confusion Cough Diarrhea Difficulty breathing Fainting, light-headedness, dizziness Hives, itchiness Nasal congestion Nausea, vomiting Palpitations Skin redness Slurred speech Wheezing • Abormal heart rhythm (arrhythmia) • Fluid in the lungs (pulmonary edema) • Hives • Low blood pressure • Mental confusion • Rapid pulse • Skin that is blue from lack of oxygen or pale from shock • Swelling (angioedema) in the throat that may be severe enough to block the airway • Swelling of the eyes or face • Weakness • Wheezing

  6. MANAGEMENT of ANAPHYLAXIS Initial Assessment supports potential anaphylaxis? YES IMMEDIATE INTERVENTION: Assess airway, breathing, circulation, mentation Inject epinephrine

  7. MANAGEMENT of ANAPHYLAXIS IMMEDIATE INTERVENTION NO Good clinical response? YES

  8. MANAGEMENT of ANAPHYLAXIS Subsequent emergency care that may be necessary depending on response to epinephrine: Consider: Placement in recumbent position Establish airway O2 IvFluids Epinephrine infusion H1 and H2 anitihistamines Inhaled bronchodilators Corticosteroids Glucagon Vasopressors Transport to emergency department or ICU NO

  9. With persistent unfavorable clinical response… CARDIOPULMONARY ARREST DURING ANAPHYLAXIS: CPR and ACLS measures Prolonged resuscitation efforts encouraged (if necessary) Consider: High-dose epinephrine Rapid volume expansion Atropine or transcutaneous pacing for asystole or pulseless electrical activity Transport to emergency department or ICU

  10. MANAGEMENT of ANAPHYLAXIS YES Observation Provision of epinephrine kits Consider consultation with allergist-immunologist The Diagnosis and Management of Anaphylaxis: An Updated Practice Parameter. Journal of Allergy and Clinical Immunology, 2005, 115; 3:S483-S523.

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  12. SUMMARY Protocol for Treatment of Anaphylaxis Diagnose the presence or likely presence of anaphylaxis. Place patient in recumbent position and elevate lower extremities. Monitor vital signs frequently and stay with the patient. Administer epinephrine by SC or IM route and, if necessary, repeat every 15 minutes. Administer oxygen, usually 8 to 10 L per minute. Maintain airway with an oropharyngeal device. Administer the antihistaminediphenhydramine, usually given parenterally. If anaphylaxis is caused by an injection, administer aqueous epinephrine into injection site to inhibit further absorption.

  13. SUMMARY Protocol for Treatment of Anaphylaxis If hypotension is present, or bronchospasm persists in an ambulatory setting, transfer to hospital emergency department in an ambulance. Treat hyportension with IV fluids or colloid replacement, and consider use of a vasopressor. Treat bronchospasm, preferably with a beta 2 agonist given intermittently or continuously.

  14. SUMMARY Protocol for Treatment of Anaphylaxis Give hydrocortisone 5 mg/kg or approximately 250 mg intraveouslyto reduce the risk of recurring or protracted anaphylaxis. In refractory cases not responding to epinephrine because a beta-adrenergic blocker is complicating management, glucagon may be useful. Medical offices in which the occurrence of anaphylaxis is likely should consider periodic anaphylaxis drills. The Diagnosis and Management of Anaphylaxis. Journal of Allergy and Clinical Immunology 1998; 101 (6 Pt 2): S465-528.

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