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This Concept Map, created with IHMC CmapTools, has information related to: Case 3, Pt previously sensitized ???? 48-96 Hours, Delayed Type ???? T cell mediated, Hypersensitivity Case #3 Furture Prevention Ask about allergies, Pneumocstis Pneumonia Treatment Bactime commonly prescribed to treat PCP Coricosteroids used as adjunct Alternatives to Bactrim --> Clindamycin and Premethrin, Pt previously sensitized ???? Exposed to Ag again, SMX/TMP Combination Drug Sulfamethoxazole, Profile ???? Male, Delayed Type ???? Pt previously sensitized, Hypersensitivity Case #3 Hypersensitivity IV Delayed Type, Trimethoprim Metabolism Substrate of CYP2C9 and 3A4, Cytotoxic T cells remain in the epidermis ???? Exposed to Ag again, Pneumocstis Pneumonia ???? Fungus called Pneumocystis jiroveci, Current Meds and conditions ???? HIV Dolugravir + Tenofovir/Lamivudine, T-cell mediated (Type IV Hypersensitivity) Hydroxylamine metabolite of SMX Reduced glutathione enzyme in HIV Pts=increased levels of metabolite in body, Current Meds and conditions ???? Pneumocystis jirovecii pneumonia Septra DS (SMX/TMP), SMX/TMP Adverse Effects HIV/immunocompromised: SJS, neutropenia, toxic epidermal necrolysis, Sulfamethoxazole Metabolism Inhibits CYP2C8, Fungus called Pneumocystis jiroveci Cause Weak immune system CD4+ T-cell levels cells per micro liter, Symptoms ???? Within next 48 hours: blepharitis conjunctival congestion erythema and lesions of eyelids oral mucosal erosions parinful, erythematous, maculopapular, vesicular lesions all over body Ulcerations in buccal mucosa, floor of mouth, surface of tongue, Disrupts folic acid pathway ???? Disrupts cellular function and DNA synthesis of pathogen