The correct hypersensitivity reaction

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Case Study Scenario
A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She
considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that “seems to never go away”.
She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few
days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined
the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous
swelling), Allergic crease (lateral crease on the nose) and inflamed nares.
Case Study Questions
Pathophysiology & Clinical Findings of the Disease.
1. Identify the correct hypersensitivity reaction.
2. Explain the pathophysiology associated with the chosen hypersensitivity reaction.
3. Identify at least three subjective findings from the case.
4. Identify at least three objective findings from the case.
Management of the Disease:
1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each.
2. Describe the mechanism of action for each of the medication classes identified above.
3. Identify two treatment options that are NOT recommended (I.e., recommended against).

 

Sample Solution

Hypersensitivity reactions (HR) are immune responses that are exaggerated or inappropriate against an antigen or allergen. Coombs and Gell classified hypersensitivity reactions into four forms. Type I, type II, and type III hypersensitivity reactions are known as immediate hypersensitivity reactions (IHR) because they occur within 24 hours. Antibodies including IgE, IgM, and IgG mediate them. The anaphylactic response is mediated by IgE antibodies that are produced by the immune system in response to environmental proteins (allergens) such as pollen, animal danders, or dust mites. These antibodies (IgE) bind to mast cells and basophils, which contain histamine granules that are released in the reaction and cause inflammation.

In ayurveda Withania somnifera is considered as Rasayana spice. The plant is notable for its underlying foundations wealthy in steroids and alkaloids and are a significant comprise of conventional ayurvedic drug planning against numerous illnesses (Williamson,2002). The major biochemical constituents of this plant are a class of optional metabolites known as withanolides. The natural movement of withanolides, particularly of the predominant withanolide An and withaferin A have been concentrated on widely by different scientists.

 

The writing pertinent to the current review entitled ” A Study on the Influence of Elicitors on major Withanolide Content in Withania somnifera JA 20″ is explored in this section under the accompanying headings:

 

2.1. Withania somnifera: Ashwagandha

 

2.2. Bioactive mixtures present in W.somnifera

 

2.3. Pharmacological properties of W.somnifera

 

2.4. Concentrates on in vitro culture procedures

 

2.5. Elicitation

 

2.6. Logical ways to deal with recognize and evaluate major withanolides

 

2.1. Withania somnifera: Ashwagandha

 

Withania somnifera Dunal (Solanaceae) prevalently known as Ashwagandha or winter cherry has been a significant spice in the ayurvedic and native clinical framework for over 3000years and is quite possibly of the most important plant in the conventional Indian frameworks of medication (Alam et al., 2011; Nathiya et al., 2012). Ashwagandha achieves the unique name as the root smells like pony (“Ashwa”) and it is accepted that on swallowing it gives force of a pony. Various pieces of Ashwagandha have huge restorative power either all in all plant remove or as discrete constituents (Bhatt et al., 2006; Gupta and Rana, 2007).

 

The sort Withania has a place with the family Solanaceae and comprises of 23

 

species. Of the 23 species, just two Withania somnifera and Withania coagulans(Linn.) Dunal have been accounted for from India. Withania Linn. family is conveyed in the east of the Mediterranean locales and South Asia. Withania somnifera is a local of drier piece of India and Africa and old world. It is developed in huge scope as business crop in Madhya Pradesh, Gujarat and a few pieces of Rajasthan. Withania coagulans is found as a business plant in the Punjab district. Withania somnifera is known as quite possibly of the most valuable spice in mollifying “vata” properties and the plant has been accounted for to have adaptogenic action, anticancer, anticonversant, immunomodelatory, against oxidative and neurological impacts and furthermore utilized in dietary purposes (Murthy and Sarala, 2010).

 

Ashwagandha gangs a few medical advantages and is a notable spice in Indian Ayurveda and was involved since hundreds of years for its extraordinary benefits (Mahima et al., 2012). Both the cutting edge clinical writing and customary Ayurveda compositions report numerous potential medical advantages of the Ashwagandha spice (Wankhede et al., 2015).

 

2.1.1. Taxonomical Classification (Bano et al., 2015)

 

Realm: Plantae Order: Tubiflorae

 

Division:Angiosperms Family:Solanaceae

 

Class: Dicotiledoneae Genus: Withania

 

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