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Things to discuss with your medical assistant if you are on allergy shots

1. Patient safety and comfort are our priority. If you had a reaction, large or small, to your previous injection, please let us know. We may need to adjust your dose. Large, local reactions can be uncomfortable, and are an indication your dose is too high. Local reactions include: swelling, redness, tenderness, and itchiness. Systemic reactions are even more problematic because they can escalate to a serious allergic reaction, even anaphylaxis. Signs of systemic reaction include the following:
• itchy palms, soles, and ears
• shortness of breath, wheeze
• facial flushing
• dizziness
• development of hives
• stomach upset
• sensation of throat closure
• feelings of impending doom
While a serious reaction is most likely to occur during the first 30 minutes after receiveing an injection, delayed reactions can occur. Please let us know if any delayed reaction has occured.
1. Is your asthma well-controlled? If you have required use of your rescue inhaler (albuterol) more than 2 times per week, your asthma may not be adequately controlled. Studies show patient’s with poorly controlled asthma are at an increased risk of severe systemic reaction to immunotherapy. Please let your medical assistant know if you believe your asthma is not well-controlled.
2. Are you feeling sick? In particular, do you have an upper respiratory infection such as a cold virus? Upper respiratory infections and allergen sensitization can work synergistically to worsen symptoms, particularly in asthmatics. We recommend all patients forego receiving allergy shots until they feel well. Any wheeze, shortness of breath, cough, or chest-tightness are indications you are not well enough to receive your shot.
3. Have you started taking medication to treat high blood pressure, cardiac arrythmia, or angina? Medications called beta blockers are commonly prescribed to treat these conditions. Please tell your medical assistant if you have started treatment with these medications. They interfere with our ability to treat severe allergic reaction/ anaphylaxis should it occur.
4. Are your pregnant? Although allergen immunotherapy is safe to continue during pregnancy, we will need to adjust your dose. Immunotherapy itself does not pose a risk to the fetus, however, anaphylatic reactions can be detrimental to the mother and the fetus. If you are in the build-up phase of therapy and you are benefitting from therapy, you can choose to continue your current dose throughout your pregnancy. If you are not currently receiving benefit from your shots, you can choose to stop therapy and re-start after your child is born. Patients who have reached the maintenance phase of therapy should continue receiving shots, especially if they are receiving benefit. We would , however, reduce your dose by 50% and build you back up after you deliver your child. Please let your medical assistant know about your pregnancy so we can discuss options with you.

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