Download KP 10

HIPERSENSITIVITAS
& PRURITUS
Ns. Zaqqi ubaidillah, M. Kep., Sp, Kep, MB
Hipersensitivitas
Definisi
• Allergic dysfunction adanya gangguan respon yang
dilakukan oleh pertahanan natural tubuh dalam
mempertahankan serangan dari virus, bakteri atau
substansi asing
• Disorders caused by immune responses are
collectively referred to as hypersensitivity reactions.
The term arose from the clinical definition of
immunity as “sensitivity” to an antigen
•
• antigens, substansi yang mampu menstimulasi
respon imun, dimana zat tersebut dapat
diidentifikasi oleh sistem imun
• Sistem imun dapat mengenali protein asing dan diri
• Sistem imun dapat mengenali antigen pada saat
pertama kali terpapar, kemudian pada saat
terpapar yang kedua akan bisa langsung
menyerang
• Atopy is a personal or familial tendency to become
sensitized and produce immunoglobulin E (IgE)
antibodies in response to ordinary exposure to
allergens
• Atopy adalah keadaan klinis dimana antibody IgE
high responder.
• Genetic predisposition to produce a prolonged IgE
antibody response to allergens that are found in the
general environment, such as serbuk sari, dust
mites, dan jamur
Patofisiologi
Respon imun terhadap allergen
Any one
confuse?
Tipe hipersensitivitas
• Pada umumnya di bagi menjadi 4
yakni, hipersesitivtas tipe 1, 2, 3
dan 4
Tipe 1
• The type 1 hypersensitive reaction is an immediate
type of hypersensitivity reaction
• The contact, inhalation, ingestion, or injection of the
allergen creates an allergic reaction mediated by
specific IgE antibodies, the cellular release of
histamine, and other vasoactive mediators,
resulting in an immediate local or systemic reaction
(anaphylaxis)
Tipe 2
• Type 2 hypersensitivity reactions are cytotoxic
reactions where the antibody (IgG or IgM) is
directed against antigen on an individual’s own cells
or against foreign antibody, such as that acquired
after blood transfusion
• This may lead to cytotoxic action by killer cells or to
lysis mediated by the complement system
Tipe 3
• Type 3 hypersensitivity reactions are immune
complex reactions where immune complexes
(antigen and usually IgG or IgM) are deposited in
the tissue.
• The complement is activated, causing local tissue
damage and inflammation
Tipe 4
• Type 4 hypersensitivity reactions are cell-mediated
reactions, which are also called delayed
hypersensitivity
• contact dermatitis after exposure to ointments
containing active drugs is the most frequent form of
drug-mediated delayed hypersensitivity
• contact hypersensitivity, tuberculintype
hypersensitivity, and granulomatous
hypersensitivity
Beberapa zat allergen
Diagnostik
• Diagnosis begins with a detailed medical history
and physical examination
• skin allergy test will be done, and blood testing
may be done to determine the allergen causing the
reaction
• When the triggers are identified, a treatment
program can be established
• The first step in treatment is to minimize exposure
to the identified allergen.
• Medications may be prescribed to reduce allergic
symptoms and inflammation.
Nursing problem
• Ineffective breathing pattern
• Ineffective coping related to anxiety, lower activity
level, and the inability to perform normal activities of
daily living
• Activity intolerance related to fatigue
• Fear and anxiety related to actual or potential
lifestyle
changes
Question
please!!!
Pruritus
Definisi
• Pruritus (itching) is one of the most common
symptoms of patients with dermatologic
disorders.
• Itch receptors are unmyelinated, ujung saraf
(brushlike) yang dapat ditemukan pada skin,
mucous membranes, and cornea
•
• Some common oral medications such as aspirin,
antibiotics, hormones (ie, estrogens, testosterone,
or oral contraceptives), and opioids (ie, morphine or
cocaine) may cause pruritus directly or by
increasing sensitivity to ultraviolet light. Certain
soaps and chemicals, radiation therapy, prickly heat
(miliaria), and contact with woolen garments are
also associated with pruritus
• Bahkan juga faktor psikologis dapat memicu
pruritus
Patofisiologi
• Scratching the pruritic area causes the inflamed
cells and nerve endings to release histamine,
which produces more
pruritus, generating a vicious itch–scratch cycle.
• Pasien menggaruk area yang gatal the integrity
of the skin may be altered, and excoriation,
redness, raised areas (ie, wheals), infection, or
changes in pigmentation may result.
• Pruritus pada umumnya sering terjadi pada malam
hari dari pada siang pada siang hari dapat
terdistraksi oleh kegiatan
• At night, when there are fewer distractions, the
slightest pruritus cannot be easily ignored.
Terapi farmakologis
• Topical corticosteroids may be beneficial as antiinflammatory agents to decrease itching
• ntihistamine, such as diphenhydramine (Benadryl)
or hydroxyzine (Atarax), prescribed in a sedative
dose at bedtime is often effective in producing a
restful and comfortable sleep
Any
question
???
Terima kasih
Arigato gozaimaze
Gamsha Hammidah