Jenis Alergi

Urtikaria
akaut
Rinitis alergi
Asma

Alergen Umum
Sengatan serangga

Gambaran
Bentol dan merah di daerah sengatan

Polen, tungau, debu rumah,

Polen, tungau, debu rumah,

Makanan

Kerang, susu, telur, ikan,

bahan asal gandum
Polen, tungau, debu rumah,
beberapa makanan
Obat, serum, bisa, kacangkacangan

Edem dan iritasi mukosa nasal

Kontriksi bronkial, peningkatan produksi
mukus, inflamasi saluran nafas
Urtikaria yang gatal dan potensial menjadi
anafilaksis
Inflamasi pada kulit yg terasa gatal,
biasanya merah dan adakalanya vesikuler
Edema dengan peningkatan permeabilitas
vaskular, berkembang menjadi oklusi
trakea, kolaps sirkulasi dan kemungkinan
meninggal

Ekzem atopi
Anafilaksis

In general, -adrenergic receptor stimulation results in excitatory responses such as

vasoconstriction, whereas -adrenergic stimulation leads to inhibitory responses such as
bronchodilation.
The -adrenergic agents are effective in the treatment of allergic nasal disease because of
their decongestant effects (see Tables 142-2 and 142-4 ). In the nose, stimulation of 1adrenergic receptors on postcapillary venules and 2-adrenergic receptors on precapillary
arterioles leads to vasoconstriction, resulting in a reduction in nasal congestion. The oral
decongestants used clinically include pseudoephedrine, phenylephrine, and
phenylpropanolamine.
Decongestants available as topical nasal sprays include phenylephrine, oxymetazoline,
naphthazoline, tetrahydrozoline, and xylometazoline. Given their efficacy and rapid onset of
action, the potential for excessive use of topical nasal decongestants resulting in rebound
nasal congestion is high. When this occurs, refraining from the use of these sprays for 23
days is necessary for recovery.
Drugs that stimulate -adrenergic receptors have been used for years in the treatment of
asthma because of their potent bronchodilator effects (see Table 143-9 ). The subclassification
of -adrenergic receptors into 1 and 2 subtypes led to the development of drugs selective for
the 2-adrenergic receptor, such as albuterol, that have the advantage of producing significant
bronchodilation with less cardiac stimulation. The

ANTICHOLINERGIC AGENTS.

These drugs inhibit vagally mediated reflexes by antagonizing the action of acetylcholine at
muscarinic receptors. Of the available anticholinergic agents, ipratropium bromide is the
most commonly used
ANTIHISTAMINES.

Histamine exerts its effects through binding with one of its three receptors, referred to as H1-,
H2-, or H3-receptors. Histamine effects triggered through H1-receptor binding are those most
relevant to allergic inflammation and include pain, pruritus, vasodilation, increased vascular
permeability, smooth muscle contraction, mucus production, and the stimulation of
parasympathetic nerve endings and reflexes.
The H1-type antihistamines prevent the effects of H1-receptor activation through reversible,
competitive inhibition of histamine by binding to the H1-receptor. As a result, antihistamines
work best in preventing rather than reversing the actions of histamine and are most effective
when given at doses and dosing intervals resulting in the persistent saturation of target organ
tissue histamine receptors.
These antihistamines are further divided into 1st-generation antihistamines, which, because of
their lipophilicity, cross the blood-brain barrier to exert effects on the central nervous system,
and 2nd-generation antihistamines, which exert minimal, if any, central nervous system
effects because of their inability to cross the blood-brain barrier owing to their size, charge,
and lipophobicity.