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Insect Allergy: Decrease Your Chances of Being Stung

Insect Allergy: Decrease Your Chances of Being Stung

Watch where you are going.

Wasps build cones in sheltered places, especially under porches and eaves. Wasps may also nest on fences or around boat docks. Hornets can build oval paper nests suspended well above the ground. Yellow jackets have a habit of nesting in the ground, under rocks, or in walls of buildings. If you see more than two yellow jackets or bees close to the ground surface, pause for a moment to see what they do or where they go. If they suddenly vanish into the fall leaves or grass, be cautious, their nest may be close by. Bees and wasps usually sting only when their nests are threatened or when they are actually touched.

Activities with particular risk include; tampering in any way with wasp nests or yellow jacket burrows. This may accidentally occur when mowing the lawn, cutting flowers, trimming hedges or shrubs, or painting a house. Wasps and yellow jackets search for food around open soda cans, trash or garbage cans. Picnic grounds and clover fields are favorite gathering places for these insects too. Never go barefoot or wear sandals outdoors.

Avoid fast, jerky motion; it excites insects.

If you are "buzzed" by a bee or wasp, never flail at it with your arms. Instead, stop or keep walking slowly. Stinging insects are more apt to attack a fast-moving object than a stationary or slow-moving one. (Sometimes, however, one must run for safety, as when a large nest is disturbed.)

Wear light-colored clothing when out (picnicking, walking in the woods, etc.)

Bees are extremely color-sensitive. Dark shades, especially brown, black and dark red, seem to anger them; floral prints also can attract bees. As every beekeeper knows, white or khaki clothing seldom bothers them. Loose-fitting clothing, such as head scarves and billowing skirts, are undesirable because a bee or wasp may become trapped in these.

Do not apply anything that has a sweet odor to your body (such as hair sprays, oils, perfumes or colognes).

Bees and wasps sense sweet orders easily. Hair oils and perfumes which contain floral odors attract them. If a bee or wasp becomes entangled in human hair, its first reaction is to sting. Shower with non-perfumed soaps.

Spray picnic area or other dangerous areas beforehand.

To avoid having yellow jackets and bees gather at a picnic table, spray area beforehand with a fast acting insecticide. Avoid insecticide sprays containing pyrethrum, as this chemical can aggravate allergy symptoms. Keep a can of insecticide in the kitchen to be used to spray the trash and garbage can area, in the glove compartment of the automobile and nearby when working outdoors for use when an insect approaches you.

Call an exterminator.

Don't do it yourself. Be sure there are no nests of yellow jackets, bees, or other wasps in the immediate area of your house, garden, or lawn. Don't try to dispose of the nest by yourself. It is a tricky business, requiring expert use of insecticides. One mistake can unleash scores of angry stinging insects.

Medical therapy of insect allergy will be discussed by your physician.

Injectable adrenaline (EPIPEN), antihistamines, or medicated sprays may be used to counter the allergy reaction. A program of emergency treatment appropriate for your specific condition will be prescribed. Please ask questions if you do not understand any part of your medical program. Allergy injection therapy may also be included in your treatment program. Allergy injections attempt to reduce the degree or amount of allergy reaction that you get when stung. Allergy injections are often very effective, although not always completely so. Also a period of months is required to build up your immunity. Therefore, you should "play it safe" and always have your emergency medicines available to treat sting reactions.

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Biologics for the Management of Severe Asthma

For many patients with asthma, their asthma is controlled by identifying and avoiding triggers, taking a daily inhaled or oral controller medication, and using a quick-relief inhaler when symptoms develop. For some patients though, these medications are not enough to control their asthma. Recently, several new medications, known collectively as “biologics,” have been approved for the treatment of moderate-to-severe asthma. Biologics are unique in that they target a specific antibody, molecule, or cell involved in asthma. Because of this, they are known as “precision” or “personalized” therapy.

What is a biologic?
A biologic is a medication made from the cells of a living organism, such as bacteria or mice, that is then modified to target specific molecules in humans. For asthma, the targets are antibodies, inflammatory molecules, or cell receptors. By targeting these molecules, biologics work to disrupt the pathways that lead to inflammation that causes asthma symptoms.  

When would you need a biologic?
A biologic is used for patients who continue to have symptoms despite use of standard daily controller medications. Symptoms of poorly controlled asthma include frequent coughing, wheezing, or shortness of breath; waking up at night with difficulty breathing; requiring a fast-acting reliever medication, such as albuterol, several times a day or week; and recurrent hospital admissions, emergency room visits, or need for oral steroids for exacerbations. Before prescribing a biologic, your doctor should make sure you are taking your other controller medications as instructed, avoiding any potential triggers for your asthma, and treat any other associated medical conditions that could be making your asthma worse.  

What are the benefits of a biologic?
The primary benefit of biologics has been a decrease in the frequency of asthma exacerbations, including emergency room visits, hospitalizations, and need for oral steroids. Other benefits include reduced asthma symptoms, reduced dosage of other controller medication, and less missed school and work days. Biologics have been shown to improve quality of life for patients with asthma. Some biologics have been found to improve lung function in patients with severe asthma.  

What biologics are available for asthma?
Currently there are six approved biologics for asthma – omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab – with several others currently in development. Omalizumab targets allergy antibodies known as IgE. Mepolizumab, reslizumab, and benralizumab all target pathways that affect eosinophils, a cell involved in allergic inflammation. Dupilumab targets a receptor for two molecules that drive allergic inflammation.  Tezepelumab blocks a chemical thought to be important in the initiation and persistence of airway inflammation. Your doctor will obtain screening tests, such as blood work or environmental allergen skin prick testing, to help decide which biologic would be best to treat your asthma. Omalizumab is approved for patients as young as 6 years old, while all the other biologics except for reslizumab are approved for patients as young as 12 years old. Reslizumab is approved for adults 18 and over.

How are biologics administered?
Unlike other medications for asthma, most biologics are currently administered in a doctor’s office either as a subcutaneous injection or as an intravenous infusion when beginning treatment. With some biologics, your doctor may want to observe you in the office between 30 minutes and two hours after administration. Many biologics may eventually be administered at home. The frequency of administration of each of these biologics are different, ranging from every two weeks to every eight weeks.

What are the side effects of biologics?
Overall, studies have shown biologics to be very safe. For one of these medications, omalizumab, there has been a small risk of anaphylaxis. In this case, your doctor will likely prescribe an epinephrine autoinjector to have in case of a severe reaction. With mepolizumab, your doctor may ask if you are at risk for certain types of parasitic infections or ask about your varicella vaccination status prior to administering. Other common side effects include soreness at the injection site, headache, sore throat, and fatigue.

How long do I need to be on a biologic?
There are currently no set recommendations on how long a patient should be on a biologic.  Guidelines recommend trialing the medication for at least four months to see if it is helping improve your asthma. Your doctor will work with you to decide how long to keep you on a biologic if your asthma is under good control.

How much do biologics cost?
Compared to other controller medications for asthma, biologics are more expensive, costing upwards of thousands of dollars per year or more. Given the cost, you and your doctor should work together to see if they are the best medications for you. You should also check with your insurance company to make sure they are covered prior to starting.

Source: https://www.aaaai.org/tools-for-the-public/conditions-library/asthma/biologics-for-the-management-of-severe-asthma

The post Biologics for the Management of Severe Asthma appeared first on Oklahoma Allergy and Asthma Clinic.

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