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ASSIGNMENT OF PHARMACOGNOSY
TOPIC:
INTRODUCTION OF ALLERGY,
TYPES OF ALLERGENS,
SYMPTOMS, DIAGNOSIS &
TREATMENT OF ALLERGY
SUBMITTED BY:
MUDAM NOOR
SECOND PROF: PHARM.D
DEPRATMENT OF PHARMACOGNOSY
FACULTY OF PHARMACY
UNIVERSITY OF SINDH
ALLERGY
“The term allergy is used to describe a response, within the body, to a
substance, which is not necessarily harmful in itself, but results in an
immune response and a reaction that causes symptoms and disease in a
predisposed person, which in turn can cause inconvenience, or a great
deal of misery.”
Word allergy was coined in 19th century from the Greek word “allon argon”
and means “to react differently”. Allergic people respond differently to
certain substances in that they develop hypersensitivity reactions to various
foods, drugs, inhaled particles, leading to symptoms and illness.
What is an Allergen?
An allergen is a protein or chemical that is capable of causing
sensitization & subsequent allergic sensitivity on re-exposure. Allergens
are substances that, in some people the immune system recognizes as
“foreign” or ‘dangerous” but cause no response for most people.
Common Allergens Include:
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Bacteria, viruses & animal parasites
Chemicals
Dust
Drugs (such as antibiotics or medications you put on your
skin)
Foods (peanuts, milk, chocolates, wheats)
Perfumes
Plants
Pollens
Smoke
Types Of Allergens:
Allergens can be classified on the basis of types symptoms, which depend on
shock organ affected by the particular allergens & its of entry into the body.
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Inhalant allergens
Injectant allergens
Contactant allergens
Ingestant allergens
Infectant allergens
Infestant allergens
INHALANT ALLERGENS
Inhalant allergens are those that are inhaled through the nose, throat, &
into the bronchial tubes & lungs.
These are the airborne particles which may cause asthma or allergy
symptoms to appear. When you breath in something you are allergic to, a
reaction is likely to occur.
Inhalant allergens include animals, dust mites, feathers, cockroachesmold
& pollens.If the symptoms are restricted to the nasal mucosa & are
manifested by by sneezing, lacrimaton, itching & sweeling of nose & eyes,
an inhalant allergy is usually detected. The condition is known as ‘sinusitis’
or ‘hayfever’.
These usually present with problems in the airways- rhinitis, itchy palate or
throat or asthma with cough, wheeze & shortness of breath.
Symptoms
Pollen interfers with the normal function of many vital organs,
including the:
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Bronchioles
Larynx
Throat
Trachea
When pollens irritate the nose, hayfever symptoms such as
congestion, sneezing & nasal discharge occur. The throat reacts
to pollen by becoming itchy & scratchy & the larynx becomes
hoarse & voice loss can occur.
Other symptoms include
Allergic shiners (dark circles under the eyes caused by increased
blood flow near the sinuses)
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Fatigue
Mental dullness
Watering eyes
Timing Of Symptoms
Symptoms worse in:
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Winter suggest house dust mite allergy
Spring suggest tree pollens
Last week of May to the first 2weeks of July suggest pollen
grains
August to the autumn suggest moulds
Hay fever
Hay fever (allergic rhinitis) is an allergy which results in irritation or
inflammation of the delicate linings of the nose or eyes. Most hay fever
is seasonal and symptoms tend to occurwhen pollen or other airborne
particles are at high level.
The most common forms of hay fever are reactions to:
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Pollens
Grasses
Pet Dander
Dust Particles
Mold Spores
Hay fever tends to be passes on through families. If you have allergies
in your family there Is an increased chance you will also get hay fever.
Hay fever is more of a nuisance, rather than a serious medical condition.
Treating Of Allergy
If you have a pollen allergy, its curcial to aoid prolonged periods
of time outdoors when the pollen level is high.
After being outside, use a nasal rinse. This is a great way to
wash out the pollen that loges in nasal passages.
Also, experts recommend that you should invest in an air purifier
for severe pollen allergies.
Over the counter medicine including Claritin, Zyrtec & Mucinex
can help relieve sneezing, itching, & couhing symptoms & hot tea
can sooth an irritated, scratchy throat.
Benadryl is also helpful but should only be used at night time, as
it usually causes drowsiness.
If these medicines are not effective, a physician can prescribe
antihistamines, corticosteroids.
Regularly dust at home, vacuum, change air filters, & keep good
hygiene.
INJECTANT ALLERGENS
Substance to which a person is allergic, which are injected into
the body. Usually drugs & insect venom, these are th substances
that penetrate the skin.
Injectants are the substances injected into the skin, muscles,
joints or blood vessels. Serum, antitoxins, vaccines
immunizations, & drugs are among injected substances.
Insect bites are also considered injectants, & various substances
can be injected through these bites.
Allergic reactions to pencillin injections are well-known to most of
the lay public.
It is estimated that anaphylactic reactions to pencillin occur with
a frequency of 1 to 5/10,000patient courses of pencillin.
In addition to pencillin products, other injectables may cause
allergies- liver extracts, antitoxins & the glandular products.
CONTACTANT ALLERGENS
An allergen capable of inducing delayed contact type
hypersensitivity of the epidermis after one or more episodes of
contact.
Any group of allergens that elicit manifestations of induced
sensitivity by direct contact with the skin or mucosa.
Direct contact with the skin of the animal can result in allergic
symptoms from contactans. Cosmetic, soaps, oils, detergents,
latex products, formaldehyde & various plan oils such as those
from poison ivy, oak can be contactant allergies.
Carpets, rugs plastics, vinyl, toys, shampoo, bath accessories &
towels can also cause contactant allergies.
When an allegen comes in contact with the body, it causes the
immune system to develop an allergic reaction in persons who
are allergic to it.
Cauases And Risk Factors:
The most common allergic diseases are allergic rhinitis, non-allergic
rhinitis, asthma, allergic dermatitis, contact dermatitis and urticaria.
(Allergic rhinitis is the most common of the allergic diseases and the
main focus of this health profile.)
Allergic rhinitis: is a general term used to apply to anyone who has
allergy-based symptoms.
Allergic rhinitis can be a seasonal problem (commonly known as "hay
fever" or pollen allergy) or a year-round problem (commonly known
as perennial allergic rhinitis).
Hay fever or seasonal allergic rhinitis is caused by allergy to pollens of
trees, grasses, weeds or mold spores.
Perennial allergic rhinitis is caused by house dust, animal danders,
mold and some foods.
Asthm: is caused by intrinsic and extrinsic (inhaled) factors.
Intrinsic factors are pollens, dust, dust mites, animal fur, animal
dander or feathers.
Extrinsic factors are respiratory infections; a cough, cold or bronchitis;
exercise and tobacco smoke or other air pollutants, and can be caused
by an allergy to a particular food or medication.
Eczema: also known as allergic dermatitis or atopic dermatitis, can be
caused by foods or other allergens.
Contact dermatitis: is caused by exposure to certain plants (such as
poison ivy or poison oak), cosmetics, medications, metals and
chemicals.
Urticaria: also known as "hives", is caused by allergy to foods, such
as nuts, tomatoes, shellfish and berries.
Hives can also be caused by medications, such as aspirin and
penicillin.
Symptoms Of Allergy
The sign & symptoms of allergic rhinitis are:
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Sneezing often accompanied by a runny nose
Coughing & postnasal drip
Itching eyes, nose & throat
Allergic shiners
Conjuctivitis (an inflammation of the membrane that lines
the eyelids, causing red rimmed, swollen eyes & crushing
eye lids
The signs and symptoms of asthma are:
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Feeling of tightness in chest
Breathlessness
Coughing
Diificulty inhaling & exhaling
Noisy breathing (wheezing)
The signs and symptoms of eczema, contact
dermatitis and urticariaare:
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Red, itchy skin
Inflammed skin
Welts (in hives)
Warning:
If a person is experiencing more severe symptoms than what is listed
above, they may be in anaphylactic shock.
Anaphylactic shock is a medical emergency which is an acute
systemic (affecting the whole body) allergic reaction.
It occurs after exposure to an antigen (allergen) to which a person was
previously sensitized.
The signs & symptoms of
anaphylactic shock include general
symptoms of common allergic
reactions:
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Swelling og tissues such as lips or joints
Wheezing, noisy breathing or shortness of breath
Rash or redness of the skin
Loss of consciousness
Anxiety
Itching of the skin
Headache
Nausea and vomiting
Abdominal cramps
Diarrhea
Low blood pressure
Convulsions
Itching of the mouth & throat
Hoarsness, change of voice
Chest pain
Feeling of warmth & flushing
Cramping of uterus
Feeling of having to urinate
Sweating
Confusion
Allergens more commonly associated with anaphylactic shock are:
certain insect venoms, drugs such as penicillin, and foods like fish,
peanuts, nuts, eggs and seeds.
Diagnosis Of Allergy:
There are three skin tests used to evaluate and diagnose allergies,
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Prick method
Intradermal test
Patch test
Prick method:
It is the most common type of skin test. This test test is done by
placing a drop of allergen extract on the skin on the back and
passing a needle through the puncture within about 15 minutes.
This test measures specific IgE attached to cells in the skin important in
allergies called "mast" cells.Skin prick testing is usually the first test
recommended when an allergy is suspected.
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It is usually carried out on the inner forearm, but if the patient has bad
eczema the test can be performed on the back .
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Ideally the allergens to be selected should be in accordance with the
patient's history
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As few as 3 or 4 or up to about 25 allergens can be tested
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The arm is coded with a marker pen for the allergens to be tested
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A drop of the allergen (extract) solution is placed by each code.
Intradermal test:
Intradermal allergy testing is another method of skin testing to help
determine whether an individual is allergic to a specific allergen. The test
involves injection of a small amount of the suspected allergen under the
surface of the skin. After about 20 minutes the area is examined for a
reaction at the site. A typical reaction looks like a small hive with swelling
and redness.
The intradermal test is more sensitive than the skin prick test and
can usually provide more consistent results.
The intradermal test uses a syringe to inject the allergen extract into the top
layer of skin in the arm, which rises a small bublle on the skin surface. Like
the prick method, a hive will appear indicating an allergic reaction.
First, your health care provider examines the skin either on your forearm or back
and cleans it with alcohol.
Then a small amount of the allergen is injected just under the skin.
Lastly, you must wait about 15 minutes to see how your skin reacts.
Patch test:
It can be used to look for the substances that might be causing
contactdermatitis. A suspected allergen is placed on the skin and
covered with a bandage for 48hours.If the patient is allergic, the
skin will be red and peel.
Allergen is applied to a patch that is then placed on the skin.
Sometimes, this is done to pinpoint a trigger of allergic contact dermatitis. If
there are IgE’s (allergic antibodies) in your body, your skin will become irritated
and may itch.
his reaction means you are allergic to that substance. Patch tests take
You must return to your physician to determine whether your skin has reacted to
the allergens.
Treatment Of Allergy:
There are three general approaches to the treatment of allergic diseases such as
allergic rhinitis,
 Avoidance
 Mediacation to relieve symptoms
 Allergy shots
Avoidance
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Wear a pollen mask mowing the grass or housecleaning.
Stay indoors in the morning (when the pollen count is at its
highes) & on windy days
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Keep windows & doors closed during heavy pollination.
Use the air conditioner in the house and car.
Don’t allow dander-producing animals in the house.
Rid the home of indoor plants.
Change feather pillows, wolen blankets & clothing to cooton or
synthetic materials.
Enclose mattress, box springs & pillows in plastic barrier cloth.
Wash sheets, mattresspas & blankets weekly in hot water.
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Remove carpets & upholstered furniture.
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Use air filters.
Medication
When avoidance or control of an allergen isn't possible, medications
may be necessary. Common allergy medications are:
Decongestants: administerd via spray or orally to nasal
passages. Exaples are oxymetazoline (Afrin) & phenyleprine
(Vicks sinex).Oral decongestants include pseudoephedrine
(Sudafed) and combinations of decongestants and analgesics.
Steriod nasal sprays: administered via spray to mute
the inflammatory response. Medication include fluticonase
(Flonase), mometasone (Nasonex), triamcinolone (Nasocort)
& beclomethasone (Beloconase, Vancenase).
Antihistamines: drugs that block the action of
histamine, which is responsible for allergic symptoms.
Short acting histamines which are generally over the counter
(non-prescription) often relieve mild to moderate symptoms,
but can cause drowsiness. Medication include ceterizine (Zyrtec),
diphenylhydramine (Benadryl), azelstine (Astelin).
Cromoglycate (Nalcrom) or related agents:
administered mostly as eyedrops or nasal sprays to help
prevent attacks.
Treatment of Eczema, Contactant Dermatitis *
Urticaria:
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Eczema (allergic dermatitis) and contact dermatitis (such as with
poison oak or ivy) can be treated with cold compresses for 30
minutes 3 times a day, and/or corticosteroid creams or ointments
(topical steroids).
Hives (urticaria) can be relieved by applying calamine lotion or by
taking type H1 antihistamine drugs.
More severe cases of hives may require corticosteroid drugs.
Question To Ask Your Doctor
About Allergies:
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Should skin testing be done?
Do you recommend nasal sprays or drops?
What are the side effects?
What other madications are recommended to relieve the
symptoms of allergies?
Do you recommend desensitization with injections?
Do allergic rhinitis (hayfever)reactions lead to sinus infctions
or asthma or any other condition?
Am I at risk for anaphylactic shock?
If so, what precautions can I take?
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Are foods causing the allergies?
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GLOSSARY
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Allergy:
An acquired, abnormal immune response to a substance, which can
cause a broad range of inflammatory reactions.
Allergen:
Anything (animal dander, pollen, or mold) that causes allergy
symptoms.
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Allergic reaction:
The body´s response to something called an allergen that comes in
contact with the skin or enters the body by inhalation, swallowing, or
injection.
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Pollen:
The tiny spores or fine powder produced by grasses and flowering
plants. Airborne pollen is a major allergen responsible for hay fever.
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Animal dander:
Scales of dried skin shed from cats, dogs, and other furry animals.
Similar to dandruff.
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Sensitization:
To become allergic as a result of repeated exposure to a specific
allergen.
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Antihistamines:
Medications that block the effects of histamine, which is one of the
substances your body releases when it reacts to allergens.
Antihistamines may help relieve sneezing and itchy, runny nose and
eye symptoms.
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Corticosteroid:
An anti-inflammatory medication that reduces inflammation in body
tissue.
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Decongestants:
Medications that shrink swollen nasal tissues. By opening up nasal
passages, they reduce nasal congestion. Decongestants offer relief
from nasal congestion after it has begun and are effective for
temporary relief.
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Dust mites:
Microscopic insects, usually found in house dust, that live in places
like mattresses, pillows, and carpets.
They don't bite or spread any germs, but their droppings and
carcasses contain a powerful allergen to which a lot of people are
allergic.
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Ingestant allergens:
Substances to which a person is sensitized that are swallowed, such
as foods, beverages, or medications.
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Inhalant allergens:
Any airborne substance small enough to be inhaled into the lungs
(such as pollen, dust mites, mold, and animal dander) that elicit an
allergic reaction.
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Injectant allergens:
Substances to which a person is allergic, which are injected into the
body. Usually drugs and insect venom.
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OTC (over-the-counter):
A term used to describe drugs that can be purchased without a
prescription from a healthcare professional.
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Symptom:
A recognizable change in a person´s physical or mental state that is a
departure from normal function, sensation, or appearance, and that
may indicate a disorder or disease.
THE END