1. Brow n, L. & Black, R. Nurses as caring: A pedagogical review . Journal of Nursing Education, 6(21), 142-150. Retrieved from the R.A Williams Library http://library.fhchs.edu Articles with a DOI Brow n, L. & Black, R. Nurses as caring: A pedagogical review . Journal of Nursing Education, 6(21), 142-150. doi:10.117/02681105076. Retrieved f rom the R.A Williams Library http://library.fhchs.edu
2. Introduction & Purpose of Paper (Abstract)
3. Patient Profile & Condition
   1. Kupstaite, R., Baranauskaite, A., Pileckyte, M., Sveikata, A., Kadusevicius, E., & Muckiene, G. (2010). Severe vancomycin-induced anaphylactic reaction. Medicina (Kaunas), 46(1), 30-33. Retrieved from the R.A Williams Library http://library.fhchs.edu.
   2. 23 Year old Male
4. Other Signs & Symptoms of Anaphylaxis
   1. Subtopic 1
5. Detailed Pathophysiology
   1. IgE-mediated hypersensitivity reaction to a foreign antigen, such as a protein, a hapten, or a pollysaccharide.
      1. Initial exposure results in the body making specific IgE antibodies to the specific antigen.
         1. These antibodies attach to receptors of mast cells and basophils
            1. Mast cells and basophils change their cell membranes and release preformed cytokines, chemical mediators, and generation of new potent mediators. These mediators produce the clinical symptoms of anaphylaxis.
            2. Subtopic 1
            3. Baophils have a high-affinity receptor for IgE and contain histamine-rich cytoplasmic granules.
            4. Basophils participate in IgE-mediated reactions similar to mast cells.
         2. Other chemical mediators
            1. arachidonic acid metabolites
            2. Leukotrienes: LTC4,D4,E4)
            3. Prostaglandins PGD2,PGF2a
            4. thomboxane A2.
      2. IgE binds with mast cell, degranulation occurs with the release of the following:
         1. Histamine
            1. Symptoms
            2. Vasodilitation
            3. Increased capillary permeability
            4. Smooth muscle spasm
            5. Histamine is mediated 4 receptor types
            6. H1
            7. Cardiac effects of H1 include, coronary artery vasospasm and increased rate of depolarization of the SA node.
            8. H1 Stimulation of nerve endings; stimulation of nerve endings, pruritis, vagal irritant receptors, increased viscosity mucous from gland secretion
            9. H2
            10. Cardiac effects of H2 stimulation include, increase in rate and force of atrial and ventricular contraction and also decreases the fibrilation threshold.
            11. H3
            12. Anaphylaxis in dogs, not relevant to humans
            13. H4
            14. Histamine in general causes bronchial tree constriction and smooth muscle contraction in the uterus and GI tract.
            15. H1 & H2
            16. H1 & H2 required for max effect of: vasodilatation, hypotension, headache, flush, increased amount of mucous
         2. Platelet activating factor
            1. Smooth muscle spasm
            2. Eosinophil infiltration with Tissue injury
            3. Topic
         3. Leukotrienes
            1. Smooth muscle Spasm
            2. Neutrophil infiltration
            3. Increased capillary permeability
            4. Vasodilitation
         4. Prostaglandin D2
            1. Smooth muscle Spasm
            2. Increased capillary permeability
         5. Eosinophil chemotactic factors
            1. Eosinophil infiltration with Tissue injury
         6. Neutophil chemotactic factors
            1. Neutrophil infiltration with Tissue injury
      3. Source: (Kagy & Blaiss, 2007, p. 53)
   2. clinical manifestation of anaphylaxis.JPG
6. Why would this occur? (Detailed) & Progression of the Reaction.
   1. Body temperature rose to 39degreec C. Sore throat
7. Immediate Treatment & Rationale
   1. Epinephrine
      1. Source:
         1. (Kagy & Blaiss, 2007)
            1. Subtopic 1
            2. Kagy, L., & Blaiss, M. (2007). Anaphylaxis. In L. Kagy, & M. Blaiss, Allergic Diseases (3 ed., pp. 51-70. DOI: 10.1007/978-1-59745-382-0_5. Retrieved from the R.A Williams Library http://library.fhchs.edu). Totowa, NJ, US: Humana Press Inc.
      2. Subtopic 2
8. Prevention
9. Conclusion