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Allergy Injection Treatment Procedures and Precautions

Allergy Injection Treatment Procedures and Precautions

Method of Administration

Allergy injections are given subcutaneously, half-way between the elbow and the shoulder along the outer aspect of the back of the upper arm, or the outside of the mid-thigh. They should not be given too shallowly in the skin, nor should they ever be given without first aspirating (drawing back on the syringe plunger after the needle is in the tissue). If blood is seen when aspirating, the needle should be withdrawn before injecting and another area should be used for the injection. If there are 2 vials (such as “LEFT” and “RIGHT”), there should be 2 injections each time shots are given unless the doctor instructs otherwise. Some injections will be given from individual numbered unit dose vials while other will be dispensed from a larger multi-dose vial according to instructions specific for an individual patient.

A disposable 1 cc allergy treatment syringe with the ½ or 5/8 inch, 25, 26 or 27 gauge, regular bevel needle should be used to give the injections.

Important Precautions

  • The injections should never be administered unless injectable epinephrine 1:1000 is immediately available and there is a reliable person other than the patient to inject it.
  • OAAC requires that allergy injections be administered by a medically competent person in a medical facility equipped to treat (possible severe) allergic reactions. This advice encompasses all patients – even doctors, nurses, and other health professionals who are allergy patients.
  • Administration of allergy shots outside of an OAAC shot treatment room (for example your physician’s office) must be cleared by your OAAC physician (not just from your primary care physician or other health care provider); please do not proceed without it.

Injection Reactions

Allergy injection treatment is intended to decrease a patient’s sensitivities so that in time he/she will feel better. Injections should not cause allergy symptoms. Whenever problems occur, please discuss it with your OAAC doctor or staff.

A local reaction to an allergy injection consists of redness, soreness, itching, and/or swelling at the injection site. Most allergic individuals can be expected to have some local reaction at times. Some will have moderate local reactions regularly, at least until they have been on treatment for many months.

Should there be an excessive (greater than a quarter or 25 cent piece in diameter and lasting more than 24 hours) local reaction after an injection, an antihistamine (like Benadryl, Claritin, Allegra, Zyrtec or Xyzal), cold compress, and topical steroid cream may be used for symptom relief. Your OAAC physician and staff must be notified of the dose number and of the name of the specific vial before more injections are given. A dosage reduction may be indicated.

Systemic (generalized) anaphylaxis reactions to allergy injections are rare (0.015 to 0.02% of injections administered at OAAC Clinics). However, if they occur, prompt treatment with Epinephrine and not just an antihistamine like Benadryl is vitally important. It could save your life. In the event of a systemic (generalized) reaction after an allergy injection, there may or may not be marked swelling at the injection site, plus a vague feeling of apprehension and itching of the palms followed by generalized hives, flushing, sneezing, nasal congestion, increased mucus production or throat clearing, difficulty breathing, coughing, or wheezing.

PATIENTS MUST WAIT 20-30 MINUTES AFTER AN INJECTION SO THAT THEY MAY BE OBSERVED FOR SIGNS OF A GENERALIZED REACTION.

This type of reaction requires treatment with Epinephrine and not just an antihistamine like Benadryl. Prompt medical attention is always needed. If the shot was given at a location other than an OAAC treatment room your clinic physician must be notified before further allergy injections are given because dosage reduction is mandatory. Your OAAC physician is always notified by staff of systemic reactions which occur at an OAAC treatment room.

Beta blocker drugs may make systemic reactions more difficult to treat and you must notify your OAAC physician if you are taking one.

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Grass Pollen Allergy

If the smells of freshly cut lawns make you sneeze, you may have a grass pollen allergy. Grass pollen is a common cause of allergy. Every spring and summer, plants release tiny pollen grains to fertilize same species plants. Grass pollen can trigger allergic reactions.

If you are experiencing these symptoms, grass pollen may be the trigger:

  • Runny nose
  • Sneezing
  • Itchy nose, eyes, ears and mouth
  • Stuffy nose (nasal congestion)
  • Red and watery eyes
  • Swelling round the eyes

 Since grass pollen grains may not be visible to the eye, your body may react even to tiny amounts of pollen in the air. With Oklahoma’s strong winds, pollen is distributed across the state.

Also known as hay fever, allergists refer to pollen allergy as seasonal allergic rhinitis.

What grasses cause allergy symptoms?

Fortunately, only a few grasses cause allergic symptoms. Where you live also plays a factor in grass allergy.

The most common grasses causing allergies are:

  • Bermuda
  • Johnson
  • Kentucky
  • Orchard
  • Rye
  • Sweet Vernal
  • Timothy

Living in Oklahoma, grass can pollinate through most of the year. Tiny, light and dry – grass pollen grains can travel for hundreds of miles.

“The first step is to get tested and diagnosed,” said OAAC Allergist Dr. Bret Haymore. “Once your allergist knows what specific allergens causing your symptoms, then we can work with you to create a treatment plan.”

Options for treatment include over-the-counter medicines, liquids or nasal sprays and prescription pills (also known as antihistamines, decongestants and nasal steroids). These can help reduce or prevent grass allergy symptoms.

“Grass allergy pollen medicines work best when you start taking them before pollen season begins,” said Dr. Haymore. “This will allow the medicines to prevent your body from releasing histamine and other chemicals that cause your symptoms.”

Another option if those medicines are no longer helping, may be immunotherapy or allergy shots. There are two types of grass allergy immunotherapy – allergy shots and allergy tablets. 

“Immunotherapy is a long-term course of treatment that can reduce or even prevent the severity of allergic reactions,” he said. “Allergy shots usually take a one-to-three-year commitment and can modify the body’s immune response to allergens.”

Allergy shots or subcutaneous immunotherapy (SCIT) are given at the OAAC clinics. Patients are monitored for any type of reaction to the shot. Most common side effects include local reactions at the injection site – redness, itching, swelling, tenderness, and pain. Less common reactions may include generalized redness, hives, itching, swelling, wheezing and low blood pressure.

Allergy tablets or sublingual immunotherapy (SLIT) can be done at home. This therapy involves placing a tablet containing the allergen under the tongue for one to two minutes and then swallowing it. Treatment must begin before grass allergy season and continues throughout grass allergy season. Taking the daily tablets may reduce grass allergy symptoms. There can be some side effects, and some can be serious. Please discuss with SLIT therapy with your OAAC provider about treatment options.

The post Grass Pollen Allergy appeared first on Oklahoma Allergy and Asthma Clinic.

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