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

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• Negative (swelling up to 15mm; i.e., dime size) – progress according to schedule. • “A” (swelling 15-20 mm; i.e., dime to nickel size) – Follow Allergist’s written instructions (e.g., continue to advance). • “B” (swelling 20 – 25 mm; i.e., nickel to quarter size) – Follow Allergist’s written instructions (e.g., repeat last dose given) • “C” (swelling persisting more than 12 hours or over 25mm; i.e., quarter size or larger) – Follow Allergist’s written instructions (e.g., decrease dosage by 1 dose). • Systemic reactions (hives, sneezing, itching, asthma, difficulty breathing, or shock) – Immediate care/action, then follow Allergist’s written instructions. • Generally, the subsequent allergen extract dose is reduced to 1/3 of the last dose that did not cause a reaction and repeated 3 times before advancing per schedule. • If the injections cause repeated reactions or are suspected of causing repeated delayed symptoms, or if reactions prevent progression of treatment, contact the Allergist for further instructions.
• Apply hydrocortisone (topical steroid) • Apply ice to site • Non-steroidal anti-inflammatory drugs (NSAIDS) to reduce swelling • Take oral antihistamine (Benadryl, Allegra, etc.) • Non-prescription pain-relievers (acetaminophen) to relieve pain
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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 and 12: How Does Immunotherapy Work? • De
Page 13 and 14: Who Benefits? •Those with… - Al
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 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
Page 62 and 63: Summary • Pull the patient's alle
Page 64 and 65: End of Selection Go to Bookmarks &
Page 66 and 67: a. Medical conditions that reduce t
Page 68 and 69: Allergen immunotherapy should be gi
Page 70 and 71: patient’s peak expiratory flow ra
Page 72 and 73: 7. Neilson L, Johnsen C, Mosbech H,
Page 74 and 75: Click the ⌧ next to the heading t
Page 76 and 77: a common practice to alternate the
Page 78 and 79: ALLERGY IMMUNOTHERAPY (AIT) PROBLEM
Page 82 and 83: 10. Those patients having their dos
Page 84 and 85: SPECIFIC INSTRUCTIONS A. PHYSICIAN
Page 86 and 87: ALLERGY IMMUNOTHERAPY RECORD NNMC,
Page 88 and 89: Immunotherapy Pre-Injection Questio
Page 90 and 91: Aeroallergen Dose Adjustment Schedu
Page 92 and 93: NATIONAL NAVAL MEDICAL CENTER: Alle
Page 94 and 95: ONGOING COMPETENCY ASSESSMENT OF UN
Page 98 and 99: eflecting current robust documentat
Page 100 and 101: Allergen immunotherapy: A practice
Page 102 and 103: J ALLERGY CLIN IMMUNOL VOLUME 120,
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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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End of Selection Go to Bookmarks &
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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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