Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

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History of Immunotherapy 1911 • Leonard Noon at the St. Mary’s Hospital, London injected extract of grass pollen into a patient whose symptoms coincided with the pollinating season of grasses 1965-present • Norman, Lichtenstein, et. al. defined AIT effectiveness in allergic rhinitis, allergic conjunctivitis, allergic asthma, and hymenoptera hypersensitivity
Who Benefits? •Those with… – Allergic disease identified through an adequate history & in vivo testing (in vitro testing is not adequately specific) – Well-defined clinically relevant allergic triggers – Significant effect on quality of life or daily function – Inadequate relief through avoidance measures and pharmacotherapy
Page 1 and 2: Immunotherapy Safety for the Primar
Page 3 and 4: Welcome to “Immunotherapy Safety
Page 5 and 6: Click the ⌧ next to the topic to
Page 7 and 8: Immunotherapy at Remote Sites Stand
Page 9 and 10: What Immunotherapy Is Not • Not p
Page 11: How Does Immunotherapy Work? • De
Page 15 and 16: Immunotherapy Efficacy • Effectiv
Page 17 and 18: Not Efficacious For… • Atopic d
Page 19 and 20: The Extracts/Vaccines • Bioequiva
Page 21 and 22: Lots of Numbers! Vial v/v W/V (exam
Page 23 and 24: Immunotherapy Phases • Maintenanc
Page 25 and 26: Reaction Prevention - Avoidance •
Page 27 and 28: Reaction Therapy - BLS+ Level • T
Page 29 and 30: Treatment Guidelines • Treatment
Page 31 and 32: Frequency of Systemic Reactions •
Page 33 and 34: Immunotherapy Safety • To lessen
Page 35 and 36: Immunotherapy Safety • To lessen
Page 37 and 38: Immunotherapy Safety • After Inje
Page 39 and 40: Immunotherapy Safety • Equipment:
Page 41 and 42: What To Expect (Demand) from the Al
Page 43 and 44: Summary • Risk factors for advers
Page 45: End of Selection Go to Bookmarks &
Page 48 and 49: • Allergen immunotherapy (allergy
Page 50 and 51: BEFORE EACH SHOT!!! • Screen pati
Page 52 and 53: instruct patient to report any abno
Page 54 and 55: • Negative (swelling up to 15mm;
Page 56 and 57: Epi-Pen Adult Epi-Pen JR TwinJect
Page 58 and 59: How to dilute from available vials:
Page 60 and 61: Vial v/v W/V AU/ML BAU/ML 5 Red 4 G
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Summary • Pull the patient's alle
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End of Selection Go to Bookmarks &
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a. Medical conditions that reduce t
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Allergen immunotherapy should be gi
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patient’s peak expiratory flow ra
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7. Neilson L, Johnsen C, Mosbech H,
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Click the ⌧ next to the heading t
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a common practice to alternate the
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ALLERGY IMMUNOTHERAPY (AIT) PROBLEM
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10. Those patients having their dos
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SPECIFIC INSTRUCTIONS A. PHYSICIAN
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ALLERGY IMMUNOTHERAPY RECORD NNMC,
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Immunotherapy Pre-Injection Questio
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Aeroallergen Dose Adjustment Schedu
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NATIONAL NAVAL MEDICAL CENTER: Alle
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ONGOING COMPETENCY ASSESSMENT OF UN
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eflecting current robust documentat
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Allergen immunotherapy: A practice
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J ALLERGY CLIN IMMUNOL VOLUME 120,
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Immunotherapy Safety for the Primar
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15. A 12 yo male presents for his a
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Immunotherapy Safety for the Primar
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Site Under Construction
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Introduction • “Anaphylaxis”
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Revised Nomenclature For Anaphylaxi
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Anaphylaxis* Is Not Rare Estimated
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Pathophysiology
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Pathophysiology
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Pathophysiology • Histamine acts
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IgE Mediated Reactions • Most Ant
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Complement-mediated • C5a, C3a, C
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Unknown Mechanisms • Exercise-ind
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Anaphylaxis Summary of Signs & Symp
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Differential Diagnosis • Pulmonar
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Anaphylaxis Grading Scale II • An
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Laboratory Studies • IgE antibodi
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Guidelines for Treatment • Treatm
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Guidelines for Treatment • Treatm
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How the Allergist/Immunologist Can
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Summary • Anaphylaxis: release of
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ANAPHYLAXIS • First reported case
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4) Hymenoptera stings Although almo
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• Sulfites are added to all the b
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mastocytosis on bone marrow biopsy.
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Antihistamines H1 antihistamines (B
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The diagnosis and management of ana
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c. The patient will be counseled co
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skin testing typically is performed
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TABLE 3 Required Information on Vac
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TABLE 6 Checklist for Safe Vaccine
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Strength of Recommendations Key cli
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Original articles Evaluation of nea
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Allergy Treatment Record Review Cha
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References Acknowledgment: Linda Co
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Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

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