Allergy Services
Allergy Information
Allergies: Allergy Basics
Allergy Shot Counseling Information
Allergy Testing
Allergies: Allergy Basics
What Are Allergies?
Allergies are an overreaction of the immune system. People who have allergies have a hyper-alert immune system that overreacts to a substance in the environment called an allergen. Exposure to what is normally a harmless substance, such as pollen, causes the immune system to react as if the substance is harmful.
What Happens During an Allergic Reaction?
When a person with a hyper-alert immune system is exposed to an allergen, a series of events takes place:
- The body starts to produce a specific type of antibody, called IgE, to fight the allergen.
- The antibodies attach to a form of blood cell called a mast cell. Mast cells are plentiful in the airways and in the GI tract where allergens tend to enter the body.
- The mast cells explode releasing a variety of chemicals including histamine, which causes most of the symptoms of an allergy, including itchiness or runny nose.
If the allergen is in the air, the allergic reaction will likely occur in the eyes, nose and lungs. If the allergen is ingested, the allergic reaction often occurs in the mouth, stomach and intestines. Sometimes enough chemicals are released from the mast cells to cause a reaction throughout the body, such as hives, decreased blood pressure, shock, or loss of consciousness.
What Are the Symptoms of Allergies?
Allergy symptoms can be categorized as mild, moderate, or severe (anaphylactic).
- Mild reactions include those symptoms that affect a specific area of the body such as a rash, itchy, watery eyes, and some congestion. Mild reactions do not spread to other parts of the body.
- Moderate reactions include symptoms that spread to other parts of the body. These may include itchiness or difficulty breathing.
- A severe reaction, called anaphylaxis, is a rare, life-threatening emergency in which the response to the allergen is sudden and affects the whole body. It may begin with the sudden onset of itching of the eyes or face and progress within minutes to more serious symptoms, including abdominal pain, cramps, vomiting, and diarrhea well as a varying degrees of swellings that can make breathing and swallowing difficult.
- Mental confusion or dizziness may also be symptoms, since anaphylaxis causes a quick drop in blood pressure.
*Allergy overview by Web MD.
Allergy Shot Counseling Information
You are starting Immunotherapy (allergy shots).
- Most
patients will be given 2 shots:
a. Pollen in left arm b. Inhalants in right arm
- You
will be required to wait 15 minutes to watch reactions and 20 minutes
after a vial test. If you cannot wait the full time
indicated, we cannot give you your shots.
- 3 types of reactions may occur:
a. Local, redness and swelling at
the injection site.
b. General, itching, sneezing,
wheezing/common allergy symptoms.
c. An anaphylactic reaction can
occur but is very rare. This causes : constriction
of the airways, resulting in wheezing, difficulty breathing, gastrointestinal effects
such as abdominal pain, cramps, vomiting, diarrhea. Please call the office if you believe that you
are experiencing an anaphylactic reaction, however if you experience life threatening symptoms,
call 911 immediately.
- Please let the nurse know of any unusual symptoms at the time of your
shots.
- Remember
to take an ANTIHISTAMINE (such as claritin, clarinex, zyrtec, xyzal, allegra, or any other antihistamine) 30 min- 2
hours prior to getting your shots.
- Serums
are prepared from your test results and are specific to each individual’s
allergies.
- Shots
are given once a week. After reaching the specified
goal in your
treatment you will be able to begin a 2 or 3 week regiment.
- Be advised: No shots will be given
to a feverish or ill patient or if in respiratory distress such as wheezing,
difficulty breathing, or to patients that have received a flu shot,
tetanus shot or any other immunization. They must wait 48 to 72 hours.
- The build up process takes place continually until the patient reaches the maximum
strength and dose. Once this has occurred, the patient will be on a maintenance
dose (same strength and same dose for the duration of therapy.)
- Therapy
will take a minimum of 3 years: Why 3
years? We are slowly building up immunities to these allergens. This leaves the
patient with fewer symptoms and little to no medication will be needed.
- We will start with the weakest
dose and strengths before gradually increasing both the dose and strength. Strengths: Start at T-2, T-1, T-0, T+1, T+2, T+3 Doses: 0.05, .10, .20, .30, .40,
.50.
- No strenuous exercises for 3 hours following shots it may
induce asthma-type symptoms.
- Patients need to schedule shot appointments we cannot work on a walk-in schedule due to the need for your serums to be brought to room temperature.
- We schedule our shots every 5 minutes,
it is very important to be on time. If for some reason you cannot
make your scheduled time, please give as a call to see if you can still be
seen.
- If you are more than 15
minutes late, you will have to reschedule.
- Clothing with easy access to
the shot area should be worn.
- Some patients may notice a
change in symptoms after a couple of months, but typically
you won’t see any changes until the next allergy season. It is common for the patients to
feel fatigue following shots - this will go away, but
may take a little while. Report any swelling bigger than 15mm and or dime size.
- Patients are required to
schedule a follow up appointment with Dr. Mushtaq
for evaluation at least once a year.
Allergy Testing
- Due to the limited space in our allergy testing room, we ask that you come by yourself unless you have medical or translation needs that require you to have someone accompany you.
- Please wear short sleeves.
- Be sure to eat breakfast and/or lunch before your appointment- you will be in our office for 1 ½- 2 hours.
- NO ANTIHISTAMINES OR ASPIRIN PRODUCTS FOR 7 DAYS PRIOR TO ALLERGY TEST.
- If you have any questions, please call our office.
Drugs that Interfere with Allergy Testing
THE MOST COMMON ALLERGY MEDICATIONS TO AVOID
Allegra Claritin Benadryl Zyrtec Clarinex AlleRx PE
Allegra-D Claritin-D AlleRx Zyrtec-D Clarinex-D AlleRx DF
Xyzal Alavert *OTC ANTIHISTAMINES*
MAO Inhibitors. Must be off for 5 daysprior to testing and then be off permanently. Cannot be given adrenaline or it will provoke hypertensive crisis.
Eutonyl (Pargyline) Matulane (Procarbazine)
Eutron (Pargyline & Methyclothiazine) Nardil (Phenelzine)
Furoxone (Furazolidone) Parnate (Tranylcypromine)
Antihistamine/Decongestant Preparations. Should be off. Omit for 7 days prior to testing.
Actifed |
Deconamine |
Naldecon |
PBZ |
Advil Cold/Sinus |
Dimetane |
Nalex |
Periactin |
Advil PM |
Dimetapp |
Nisaval |
Polaramine |
Allegra/Allegra-D |
Diphenhydramine |
Nolahist |
Poly-Histine |
Astelin Nasal Spray |
Dramamine |
Nolamine |
Ritalin |
Benadryl |
Excedrin PM |
Novahistine |
Robitussin CF |
Chlor-Trimeton |
Glucosamine/ |
Omnaris Nasal Spray |
Rondee |
Chlorpheniramine Maleate |
Chondroitin |
Optimine |
Ru-Tuss |
Chondroitin |
Isoclor |
Optivar Eye Drops |
Rynatan |
Clarinex/Clarinex-D |
Kronofed |
Pataday |
Tavist |
Claritin/Claritin-D |
Marax |
Patanase Nasal Spray |
Tavist-D |
Comhist |
Myidyl |
Patanol Eye Drops |
Zyrtec/Zyrtec-D |
*Please refrain from taking all cold medications, nose drops and spray, cough medications, cough drops and other antihistamines in any form.
H2 Antagonists - Anti-Nausea Medications. Should be off for 5 days prior to testing.
Tagamet (Cimetidine) Atarax
Zantac (Ranitidine) Vistaril
Zatiden (Ketotifen) Meclazine
Phenergan Pepcid
*STOP ANY LIKE MEDICATIONS*
Beta Blockers - Should be off for 3 weeks prior to testing and then permanently for immunotherapy treatment.
Diovan
Betapace (Sotalol) Normodyne (Labetolol HCL)
Blocarden (Timolol Maleate) Normozide (Labetolol & HCTZ)
Brevibloc (Esmolol HCL) Sectral (Acebutolol HCL)
Cartrol (Carteolol HCL) Tenoretic (Atenolol & Chlorthalidone)
Corgard (Nadolol) Tenormin (Atenolol)
Corzide (Nadolol & HCTZ) Timolide (Timolol & HCTZ)
Inderal (Propranolol) Toprol XL (Metaprolol Succinate)
Inderid (Propranolol & HCTZ) Trandate (Labetolol HCL)\
Kerlone (Betaxolol HCL) Visken (Pindolol)
Levatol (Penbutolol Sulfate) Zebeta (Bisoprolol)
Lopressor (Metoprolol Tartrate) Ziac (Bisoprolol & HCTZ)
Trycyclic Antidepressants - Must be off 6 weeks prior to skin testing and then may continue for immunotherapy.
* The patient must be weaned off by the prescribing doctor and substitute another drug if desired. Patient must do this under doctor’s supervision or severe depression could result from stopping medication abruptly.*
Adapin (Doxepin HCL) Meravil (Amitriptyline)
Apo – Trimip (Trimipramine Maleate) Pamelor (Nortriptyline)
Asendin (Arnoxapine) Rolavil (Amitriptyline)
Aventyl (Nortriptyline HCL) Sinequan (Doxepin)
Elavil (Amitriptyline) Surmontil (Trimipramine Maleate)
Endep (Amitriptyline) Trofamil PM (Impramine HCL)
Emitrip (Amitriptyline) Trazadone (Desyrel)
Endlil (Amitriptyline) Triadapin (Doxepin HCL)
Etrafon (Combination Drug) Trialic (Combination Drug)
Impril (Imipramine HCL) Tripramine (Imipramine HCL)
Levate (Amitriptyline) Triptil (Protriotyline HCL)
Limbitrol (Combination Drug) Vivactil (Protriotyline HCL)
Anti-Inflammatory Drugs - Must be off 7 days prior to skin testing.
Aspirin Celebrex
Motrin Aleve
Flexeril Exedrin (PM/Cold & Sinus)
Ibuprofen Medications Advil
Vioxx Naprosyn (Naproxen)
Alka-Seltzer Cold meds
Meloxicam (Mobic) Cough Drops
Vitamins (all kinds) Tylenol for Arthritis
*Patients are only allowed to take PLAIN TYLENOL*
Allergy Testing Form
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