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

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
(