Immunotherapy Flashcards
SLIT contraindications
- uncontrolled asthma
- hx hypersensitivity to the ingredients in SLIT
- hx of severe local rxn to SLIT
- hx of EoE
- hx of reaction on any SLIT products
- active mouth ulcers, lichen planus or dental extractions
Indications for allergen specific IT (AIT)
- pts with stinging insect allergy
- pts with allergic rhinitis or allergic asthma who have evidence of sIgE to clinically relevant allergies, this includes patients who:
- do not achieve control of sx with avoidance measures and pharma
- do not want ongoing to long term meds
- experience undesirable SE with meds
- pats with AD and associated aeroallergen sensitization (may be considered) - can consider VIT in patients who get disabling large local reactions (B)
- can help AD in patients with aeroallergen sensitization (B)
CI to AIT
- pts with severe or uncontrolled asthma
- significant co morbid disease such as CVD
- patients on BB (absolute CI to AIT, relative with VIT)
special considerations in AIT
- Children < 6 years
- Pregnancy
- Elderly
- pts with malignancy, ID or AI disease
Oralair contain which grasses?
timothy
cocksfoot
rye grass
meadow grass
sweet vernal grass
age for oralair
age 5-50
start 16 weeks before season
grasstex age indication, initiation timing, dose
> 5 years old and 8 weeks before season
dose is 2800 BAU
ragwitek age indication, initiation, dose
5 y.o
12 weeks before the season
12 Amb a 1 U
acarizax age indication, initiation and dose
18-65 years, any time of year, 1 sublingual tablet daily
Tree pollen season in
1. BC
2. Prairie
3. ON and QC
4. Maritimes and NFL/L
- early feb to mid july (costal, deciduous)
late march to mid july (interior, deciduous) - first week april to june
- april
- late march to june
name some deciduous trees
alder, birch, oak, elm, willow, poplar
Grass pollen season in
1. BC
2. Prairies
3. ON and QC
4. Maritime and NFL?L
- end of april to september
- may to september
- late may to june
- mid may to sept
Mould spores by province:
1. BC
2. Prairies
3. ON and QC
4. Maritimes
- present throughout the year, except for a few weeks when ground is frozen
- Spring , summer and early fall
- spring, summer and early fall
- late summer and early fall
Weed pollen by province
- BC - minimal ragweed
- mostly nettles and sage, some ragweed in Manitoba
- ON - Aug to first frost
- Maritimes - Aug to first frost
How to make IT safe in your office
- enquire about current medical conditions
- peak flow check if history of asthma
- waiting time of 30 mins after shot
- ensure pt is informed of S/S
- switch pts off BB and ACEi