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Teaching Curriculum: Immunotherapy (allergy shots)

Priorities:
Pediatrics 2, Internal Medicine 2
Family Practice 2, Student 3

OBJECTIVES
Upon completion the rotator should be able to:

  1. List the indications for allergen immunotherapy including:
    1. the presence of IgE-mediated allergy
    2. clinical symptoms on exposure to the relevant allergens
    3. unavoidable exposure to allergens to which the patient is sensitive
    4. inadequate response to medical treatment and environmental control
  2. List the contraindications for allergen immunotherapy including:
    1. concomitant treatment with beta adrenergic-blockers or ACE inhibitors
    2. cardiovascular insufficiency making it unlikely that the patient would survive anaphylaxis
    3. pregnancy is a relative contraindication
  3. List equipment that should be available in any location where immunotherapy is given including:
    1. epinephrine
    2. inhaled beta agonist
    3. IV fluids
    4. oxygen
    5. cardiac crash cart
  4. List safety precautions to take when giving immunotherapy and rationale for these precautions including: a)obtaining interim medical history and history of any reactions to previous injection(s)
    1. measure peak flow before giving shots in meta- or unstable patients
    2. patients should wait 20-30 minutes
    3. shots should be given in a medical facility
  5. Describe the treatment of a systemic reaction to an allergy shot.

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