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

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174 Amin, Liss, and Bernstein J ALLERGY CLIN IMMUNOL JANUARY 2006 TABLE I. Summary of key findings from the Near Fatal Reaction Survey and proposed recommendations aimed at preventing life-threatening reactions after immunotherapy injections Study findings Patients with reduced FEV 1 (
J ALLERGY CLIN IMMUNOL VOLUME 117, NUMBER 1 Amin, Liss, and Bernstein 175 should include treatment with epinephrine, diphenhydramine, and corticosteroids. The major findings of this survey and the proposed recommendations aimed at preventing life-threatening reactions after immunotherapy injections are listed in Table I. These recommendations address measures aimed at preventing severe reactions associated with moderate to severe airway obstruction, prior systemic reactions, reactions during the height of an allergy season, and dosing errors. In conclusion, NFRs are not uncommon, and the incidence of fatal immunotherapy reactions has not changed in the past 40 years. More effort is needed to identify and develop methods to control risks associated with NFRs. 7 NFRs occur more frequently than FRs. Near-fatal events were managed successfully with prompt administration of epinephrine in physician-supervised clinic settings, affirming recent recommendations of the Joint Task Force Allergen immunotherapy practice parameters that immunotherapy be given in a setting where procedures that can reduce the risk of anaphylaxis are in place and where the prompt recognition and treatment of anaphylaxis are assured. 8 Patients with asthma and reduced lung function (
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Immunotherapy Safety for the Primar
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Welcome to “Immunotherapy Safety
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Click the ⌧ next to the topic to
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Immunotherapy at Remote Sites Stand
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What Immunotherapy Is Not • Not p
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How Does Immunotherapy Work? • De
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Who Benefits? •Those with… - Al
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Immunotherapy Efficacy • Effectiv
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Not Efficacious For… • Atopic d
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The Extracts/Vaccines • Bioequiva
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Lots of Numbers! Vial v/v W/V (exam
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Immunotherapy Phases • Maintenanc
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Reaction Prevention - Avoidance •
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Reaction Therapy - BLS+ Level • T
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Treatment Guidelines • Treatment
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Frequency of Systemic Reactions •
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Immunotherapy Safety • To lessen
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Immunotherapy Safety • To lessen
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Immunotherapy Safety • After Inje
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Immunotherapy Safety • Equipment:
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What To Expect (Demand) from the Al
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Summary • Risk factors for advers
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End of Selection Go to Bookmarks &
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• Allergen immunotherapy (allergy
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BEFORE EACH SHOT!!! • Screen pati
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instruct patient to report any abno
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• Negative (swelling up to 15mm;
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Epi-Pen Adult Epi-Pen JR TwinJect
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How to dilute from available vials:
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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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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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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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15. A 12 yo male presents for his a
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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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Immunotherapy Safety for the Primary Care ... - U.S. Coast Guard

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