药物过敏试验及过敏反应的处药物过敏试验及过敏反应的处理药物过敏试验及过敏反应的处理药物过敏试验及过敏反应的处理.ppt

药物过敏试验及过敏反应的处理  Medication allergy test and management of allergic reaction Tracy Zhao Content Penicillin allergy test Streptomycin allergy test Tetanus allergy test Cephalosporin allergy test Iodine allergy test Procaine allergy test 学习目标 掌握青霉素过敏试验方法、结果判断、过敏反应的临床表现、预防和急救处理原则。 掌握TAT脱敏注射法。 熟悉青霉素过敏反应的原因。 熟悉链霉素、破伤风抗毒素、普鲁卡因、碘过敏试验的方法及结果判断。 Case study： One patient has got penicillin skin test 5min before , now he suddenly feels chest tightness, shortness of breath with pale, cold sweat, his blood pressure is at 10 / 7.0Kpa ( 75 / 52mmHg ), pulse is weak. What is this phenomenon? How do you manage it if you are a nurse on duty？. Mnagement of Allergic shock The most severe alergic reaction is also called anaphylaxis or anaphylactic shock 1.stop medicine. 2.give 0.1% adrenaline (epinephrine ) via subcutaneous injection. 3.oxygen inhalation. 4.anti - allergy 5. correction of acidosis. 6.expand blood volume. 7.resuscitation. 8.close observation of disease The sooner that epinephrine is given, the greater the chance for survival N: Mr. Zhao, you have got pneumonia. We’ll give you some penicillin injections. First, I’ll give you a penicillin allergy test. Have you used penicillin before? P: Yes, I have. N: Are you allergic to it? P: No, never. N: Is there anybody else in your family allergic to it? P: I think there is nobody. N: Are you allergic to any other drugs? P: No. serum sickness-like reaction 于用药后7～14天出现，临床表现与血清病相似， Fever, Joint swelling and pain, Itchy skin, Urticaria, Generalized lymphadenopathy abdominal pain Watery, red eyes 三、破伤风抗毒素过敏反应试验及脱敏注射法 破伤风抗毒素（tetanus antitoxin,TAT)是马的免疫血清，对人体是一种异种蛋白，具有抗原性，注射射后易出现过敏反应。 TAT引起过敏反应率5%～30%，其中有约十万分之一的致死率。 用过TAT超过1周者，如需再用，应重做过敏试验。 （一）过敏试验法 1、试验液的配制 2、试验方法 剂量：15 IU 时间：20分钟 结果判断： 阴性：局部无红肿、无异常全身反应。 阳性：皮丘红肿，硬结直径大于1.5cm，红晕范围直径超过4cm，有时出现伪足或有痒感。全身反应以血清病型反应多见。