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Hypersensitivity Reaction to Lisinopril
Treatment
Most appropriate treatment for this patient is to first establish an open airway. The patient has increased respiratory rate which could indicate that the patient has some trouble breathing, but the patient 02 sats indicate that the patient is receiving adequate amount of oxygen in the airways. The patient should be given Antihistamine or Epinephrine, bag of normal saline and monitored for further symptoms. The medication should be discontinued.
Histamine contracts bronchial smooth muscles causing bronchial constriction, increases vascular permeability, causing edema, and causes vasodilation increasing blood flow to the affected area. This is why the patient was experiencing swelling of the lip, uvula, and difficulty breathing.
The products of mass cell degranulation can modulate almost all aspects of an acute inflammatory response. The most potent mediator is histamine, which affects several target cells.
Hypersensitivity Reaction to Lisinopril
Pathophsiology of sx
Type I: IgE-Mediated Hypersensitivity Reactions are mediated by antigen specific IgE and the products of tissue mass cells.
57 y/o male with hx of HTN placed on Lisinopril 20mg daily. Pt presents to ER with swollen uvula, and mild upper lip swelling, difficulty breathing, and swallowing. Pt has increased respiratory rate at 24, lungs are clear, and pt exhibits no respiratory distress.
Colette Womack
Nur 603 Unit 1.2
Saint Joseph's College of Maine
Reference:
McCance, K.L., Huether, S.E., Brashers, V.L.,
& Rote, N.S. (2010). Pathophysiology: The
Biologic Basis for Disease in Adults and
Children. (6th. Ed) Philadelphia: Mosby
Hypersensitivity reactions require sensitization against a particular antigen that results in primary and secondary immune responses. An individual is sensitized when an adequate amount of antibodies or T cells is available to cause a noticeable reaction on re- exposure to the antigen. The patient became sensitized quite rapidly after single exposure to the antigen.
This patient is experiencing a type I Hypersensitivity Reaction to the newly prescribed medication Lisinopril.