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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

Conditions Treated

Recent News

Asthma, Allergies and Pregnancy
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Asthma, Allergies and Pregnancy

 

If you are pregnant and have asthma or allergies, you may feel uneasy about taking medications, but it is very important to keep your symptoms under control.

How do you stay healthy and know which medications are best for you during your pregnancy?

An allergist / immunologist, often referred to as an allergist, can tell you which asthma and allergy medications are the safest and most effective to take throughout pregnancy. Make an appointment with an allergist soon after you discover you are pregnant to develop or review your personal treatment plan and to give you peace of mind.

In the meantime, here are answers to some common questions.

Can women with asthma have safe pregnancies?
Yes. With good asthma management, you can keep your asthma under control and have a healthy baby.

How does uncontrolled asthma affect the fetus?
Uncontrolled asthma symptoms can cause a decrease in the amount of oxygen in your blood supply. The fetus gets its oxygen from your blood. Since a fetus needs a constant supply of oxygen for normal growth and development, managing asthma symptoms is very important to allow you and your baby to get enough oxygen.

Is it safe to take my asthma medications?
The risks of asthma flare-ups are greater than the risks of taking necessary asthma medications. Studies show that most inhaled asthma medications are safe for women to use while pregnant. However, oral medications (pills) should be avoided unless necessary to control symptoms. Knowing which medications to take is a good reason to stay in close contact with your allergist so he or she can monitor your condition and alter your medications or dosages if needed.

Will being pregnant affect my asthma symptoms?
Pregnancy may affect the severity of your asthma symptoms. One study showed that asthma symptoms were worse in 35% of pregnant women, improved in 28% and remained the same in 33% of pregnant women. Asthma has a tendency to get worse in the late second and early third trimesters.

Can I continue to get allergy shots during pregnancy?
Allergy shots (a form of immunotherapy) are safe to take while you are pregnant. As always, your allergist will monitor your dose to reduce the risk of an allergic reaction to the shots. These reactions are rare; however, a reaction could be harmful to the fetus. Allergy shots are not started on patients who are pregnant but can be continued on patients who become pregnant while receiving it. Although current immunotherapy doses can be maintained during pregnancy, doses should not be increased until after delivery.

What should I avoid if I have asthma or allergies?
Whether you are pregnant or not, you should stay away from things that trigger your symptoms. This might include dust mites and animal dander, and irritants such as cigarette smoke.

Can women with asthma perform Lamaze?
Most women with asthma are able to do Lamaze breathing techniques without any problems. Asthma symptoms are rare during labor and delivery in women whose asthma has been managed during pregnancy.

Can I breastfeed if I am taking medications for my asthma or allergies?
Breastfeeding is a good way to increase your child's immunity, and it is strongly recommended. Medications recommended for use during pregnancy can be continued while nursing, because the baby gets less maternal medicine through breast milk than in the womb. Your allergist can discuss with you the best treatments while nursing.

Healthy Tips
Although these are common questions during pregnancy, each patient's individual treatment varies. It is best to visit your allergist regularly during pregnancy so that any worsening of asthma can be countered by appropriate changes in your asthma management plan. Make sure to discuss any specific concerns with your physician to ensure the healthiest pregnancy for your well being and that of your baby.

• You can have a healthy pregnancy if you have asthma or allergies.
• Managing your symptoms is very important during pregnancy.
• Do not stop taking your medications.
• An allergist has special training to develop or review a treatment plan that is right for you while you are pregnant.

 www.aaaai.org

 

The post Asthma, Allergies and Pregnancy appeared first on Oklahoma Allergy and Asthma Clinic.

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