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Allergy Vaccine
Therapy (Allergy Shots)
How Does It Work? Allergy vaccine therapy is a process
in which an allergic patient can become desensitized to those pollens and
other inhalant allergens that trigger allergic rhinitis (nasal congestion),
allergic conjunctivitis (itchy, teary eyes), asthma and bee sting
reactions. Small doses of the actual
allergic substance are injected weekly. Each week the dose is increased.
Gradually a protective antibody, also known as Immunoglobulin G, is formed to
block the allergic reaction. The improvement induced by allergy
vaccine therapy is gradual. Many patients notice an improvement within the
first six (6) months at which time the patient should schedule a 6-month
evaluation appointment. Progress is evaluated every six months to one year.
Allergy vaccine therapy does not work in about 5% of patients who were
correctly diagnosed to have significant allergies. How
Long Should Someone Receive Immunotherapy? A two (2) year period is adequate to
assess the success of treatment. If
maintenance full dose has been achieved, one should notice a significant
improvement in symptoms. At year 4 or 5, a trial of
discontinuing the allergy vaccine therapy can be considered. After allergy
vaccine immunotherapy is stopped, symptoms may return at a rate of 20% the
first year, 30% the second year and up to 50% after three or more years. Who
Might Consider Immunotherapy? Allergy vaccine therapy is
recommended for patients who have significant allergies. This includes
patients with seasonal allergies such as hayfever, or with chronic allergies
such as mite, pet, or mold allergy. When these allergies result in 1)
bothersome symptoms 2) frequent upper respiratory infections, such as
sinusitis and or asthma 3) require an “excess” of medications for control,
then allergy vaccine therapy is usually helpful. How
is Allergy Diagnosed? The most important
diagnostic tool is the history of the illness. The patient’s description of the problem
leads to a diagnosis 90% of the time. Allergy skin tests are used to confirm
this impression and to define exactly which allergens are involved. For over 75 years allergy skin testing has
been the best method of identifying allergens. Immunotherapy
and Pregnancy Only because of the malpractice
climate, allergy shots are usually not started for a woman during pregnancy,
though there is no medical reason not to do so. If a woman has been receiving
immunotherapy and becomes pregnant, she may safely continue the shots during
the pregnancy. Immunotherapy has been
used for 75 years and does not harm the baby. Reactions
to the Allergy Shots There are two (2) kinds of reactions
to allergy shots: Local and Generalized (Systemic). · Local: Reactions occur at the site of the injection on the arms (where the shot was given). Redness & itching are frequent and are not a reason to hold or decrease the dose. Swelling or a lump that is irritating are reasons to hold or decrease the dose. This might occur in the office during the 20-minute waiting period or at home over the next 24 hours. Patients are asked to tell the nurse before the next injection about any swelling. We want to know how large it is… Is it the size of a dime,nickel, quarter, or larger? We can adjust the dose of future injections. An ice pack and an antihistamine, such as Allegra or Claritin, can be used to reduce any swelling. Claritin and Allegra are non sedating allergy pills. Allegra 60mg can be taken 2 caps together to start then 1 capsule every 12 hours thereafter as needed or Allegra 180mg. 1 capsule one time daily for any local reactions. However Claritin 10 mg can be taken 2 tablets together to start then 1 tablet every 24 hours thereafter as needed. Claritin is available in a Redi-tablet or pill form. Patients are asked to call the office during office hours to report these reactions.· Generalized (Systemic): Reactions occur when there is any chest tightness, breathing difficulty, throat or lip swelling, hives,itchy throat, palms or generalized body itchiness,dizziness or an overall feeling of warmth in the face and body. This usually occurs in the first 10 minutes after the injection but can occur over the first hour. This is a strong reaction, not a minor feeling, which sometimes starts with a general feeling of itchiness. Other times it starts with a tickle or tingling in the throat. If this happens, immediately take Allegra (2) 60mg caps or (1) 180mg tab, or Claritin (2) 10mg tabs, or any full dose antihistamine. Then either immediately call our office for further instructions or return to our office for evaluation and treatment of this reaction. If the office is closed and you are unable to reach us, then immediately go to the nearest emergency room. If someone else can drive you, this would be best. Patients are requested to have an antihistamine (available from the nurse) with them in a purse, a pocket or glove compartment of their car.Drugs To Be Taken Cautiously While On Allergy Vaccine Therapy If any other physician wants to put you on any of the following
medications which all contain a family of drugs called Beta Blockers, it is important to notify him/her that you are on
allergy vaccine therapy. If your are currently
taking a Beta-Blocker, please notify your doctor or a nurse. Beta-Blocker
drugs can interfere with epinephrine (adrenalin) which is the most important
drug used to treat severe allergic reactions. |
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The
following is a list of Beta-Blockers used to treat high blood pressure:
· Brevibloc· Blocadren (Timolol)· Cartrol (Carteolol)· Corzide (contains Nadolol)· Corgard (Nadolol)· Inderide (contains Propanolol)· Inderal (Propanolol)· Kerlone (Betazolol)· Lovatol (Penbutolol)· Lopressor (Metoprolol)(Toprol)· Lopressor HCT (contains Metoprolol) |
· Normadyne (Labetolol)· Normozide (Alph,Beta)· Sectral (Acebutolol)· Tenoretic (contains Timolol)· Tenormin (Atenolol)· Timolide (Timolol)· Toprol XL (Metoprolol)· Trandate (Labetolol)· Visken (Pindolol)· Zebeta (Bisoprolol)· Ziac (contains Bisoprolol) |
Intraocular
Beta-Blockers (eye medications) include: · Betagan (Levobulol)· Betatopic (Betazolol)· Betatopic S· Timoptic (Timolol)· Xalatan (Tatanaprost solution) |