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Oral Immunotherapy

admin — Tue, 03 Nov 2020 17:03:44 +0000

Skin Prick Test

admin — Wed, 15 Jan 2020 09:55:53 +0000

Drug Allergy

Drug Allergy is a common adverse reaction to medication. A same medication may not cause any reaction to a person, yet may cause unforeseen allergic reactions to another person. An allergic reaction occurs when the body’s immune system mistaken a harmless substance as an allergen, in the case of a medication, triggering a cascade of allergic events.

What are the Common Medications that can produce Allergic Reactions?

Antibiotics, such as penicillin
Non-steroidal anti-inflammatory drugs (NSAIDS), Aspirin
Anti-epileptic medication
Chemotherapy medication

What are the Symptoms of Drug Allergy?

Drug Allergy manifestations differ individually, with a wide-spectrum of symptoms such as

Skin itch
Rashes, such as hives
Respiratory symptoms such as breathing difficulty, wheezing, runny nose
Facial swelling
In severe end spectrum of drug allergy, one can potentially develop anaphylaxis that if not being reversed and treated on time, can lead to death. You should seek immediate medical attention if you suspect of having anaphylaxis.

You may develop various different adverse reactions to medications that can range from stomach upset from aspirin, to diarrhea caused by antibiotics. Some people who are taking certain blood pressure medication such as ACE-I (Angiotensin Converting Enzyme Inhibitors), can develop cough, facial and tongue swelling.

What do I expect when I consult my doctor for Drug Allergy?

A drug history and a history of relevant symptoms are important. It would be useful to obtain the timeline relation between the start of culprit of medication and the onset of the symptoms. Often, you may be taking multiple drugs concurrently. Your doctor will work with you to produce a drug chart to see the correlation of the drugs and the allergic symptoms.

Allergy testing such skin prick tests, blood tests, or even oral challenge test may be offered to certain suitable patients. Your doctor may work together with immunologist or allergist to further evaluate your Drug Allergy.

What are the Treatment and Management of Drug Allergies?

When drug allergic reactions occur, the offending drug should be stopped. Your doctor is likely to prescribe you antihistamine, corticosteroid or even epinephrine during serious allergic reactions.

In circumstances where there is no other alternative medication available, and the allergic medication is essential, you may be offered a desensitization procedure. Your doctor will gradually introduce the medication in small doses and monitor closely for any adverse reactions to achieve the maximum possible dose that you can tolerate and simultaneously aiming to achieve a therapeutic dose.

Although Drug Allergies can be unforeseen, especially when a person is taking a new medication, it is important to keep your doctors, dentists and pharmacists up to date on any known drug allergies. One should always be constantly vigilant on the symptoms and red flags of Drug Allergies. When in doubt, speak to your doctors.

The post Skin Prick Test first appeared on Ear & Allergy Clinic Singapore.

SLIT

admin — Wed, 15 Jan 2020 09:55:05 +0000

Allergic reaction

An allergic reaction occurs when the body’s immune system reacts normal particles which are usually harmless (also known as allergens). Whilst these substances do not usually cause any issues, in individuals who have allergy, their body defense system sees this allergen as threat and mount a response against these particles.

Common allergens include:

Protein produced by house dust mites
Pollen
Molds
Pets
Food such as peanut, milk, eggs, tree nuts
Insects such as bees and wasps
Medicine

Allergy is more common in people with atopy (genetically more prone towards allergy), positive family and personal history of allergic rhinitis, eczema and asthma.

Allergic reaction is triggered when a person is in contact with an allergen, the body recognizes the allergens and triggers an defense response. This leads to the release of a substance known as histamine. Histamine can induce inflammation, swelling, and itching making one feel uncomfortable.

Allergy Response Involves Various Organs of the Body

In the respiratory tract, one can present with sneezing, runny nose, coughing, wheezing, breathlessness. There is a strong association of allergy with allergic rhinitis and asthma.

In the gastrointestinal system, an allergic response can trigger nausea, vomiting, abdominal pain and cramps, or diarrhea.

Allergy Response in the Skin

In the skin allergy, one commonly presents with eczema, swelling in particularly over the gravity dependent areas such as the eyes, lips, mouth (angioedema) and developes nettle-like rashes (hives). These 3 conditions are further discussed in separate individual articles.

Severe Allergic Reaction

Sometimes, the allergic reactions can be very serious and even be life-threatening. This a condition known as anaphylaxis. This usually occurs within minutes to hours where one is exposed to allergen, and presents with acute breathlessness, wheezing, throat swelling, lip and mouth swelling, puffy eyes, rashes, and drop in blood pressure. Those who has a history of anaphylaxis should always carry an emergency adrenaline pen injection known as Epipen. It is a complete reversible condition, yet one can succumb to the condition if delay seeking treatment.

How can I test for Allergy?

Allergy to specific allergens can be detected via blood tests or skin prick test. Your doctor will discuss with you on the pros and cons of each tests and which option is suitable to individual concerns and condition.

RAST Blood Test:

RAST Blood test is used to detect IgE antibodies that are produced against certain allergens. Currently, there are multiple range of allergen panels that can be tested through IgE antibodies blood tests.

Skin Prick Test:

Skin prick test is a procedure performed over the inner forearm or upper back of a patient. It involves introduction of allergens into the skin via small sterile needles that penetrates the skin surface. The tested area of the skin will be marked and the skin will be pricked with small drops of different allergens. Most patients tolerate the test well with minimal discomfort. Your doctor will review the tested area of the skin, monitor for any evidence of redness, bumpy swelling, and measure the size of swelling (if any). If you are sensitive towards a particular allergen, you may experience mild redness and itchiness over the tested area.

How Safe is Skin Prick Test:

The test is offered in clinic setting with close monitoring from your health care providers. Severe reaction to skin prick test is uncommon.

Skin prick test is not suitable for

Those with history of anaphylaxis to that particular allergens
People with severe skin inflammatory conditions that affect most areas of their skin such as eczema or psoriasis
One that is on oral antihistamine and is not able to stop prior skin prick test

What are the Treatment Options for my Skin Allergy?

Avoidance of the culprit allergens
Adequate moisturizer. Consider soothing calming moisturizing cream
Antihistamine to ease the irritation, itch, inflammation and swelling
Steroid to reduce hypersensitivity, inflammation and swelling
Introducing Immunotherapy. This works by desensitizing and down-regulating the body
immune system against specific allergen. It is feasible by repeated regular small exposure to specific allergen. Immunotherapy can be administered by sprays underneath the tongue (Sublingual sprays)

What can I do if I have Skin Allergy?

Write a diary on where and when a reaction occurs
Reduce the risk of an allergic reaction by avoiding the allergen wherever possible
Speak to your doctor, to understand the treatment options available

The post SLIT first appeared on Ear & Allergy Clinic Singapore.

What Are Allergies?

admin — Wed, 15 Jan 2020 09:52:26 +0000

Introduction to Allergies

Allergies can occur to anyone, anytime. Allergies can affect our daily activities and reduce our quality of lives.

Allergies occur when the body’s immune system reacts to a usual harmless substance (known as an allergen). Allergen normally do not cause any issues in most people, however, in allergic individuals, the body’s immune system identifies the allergen as a threat and mount an inappropriate response to it. This is known as an allergic reaction.

What are the Common Types of Allergies?

Allergies can occur in numerous types, affecting various parts of the body. Types of allergies include skin allergy, food allergy, hay fever, allergic rhinitis, eye allergy, insect stings allergies, latex allergy, pet allergies and drug allergies.

Are Allergies in the Genes?

You may notice someone in your family having allergies too. Allergies can be hereditary. Allergies are more common in people with a atopy background, with a positive family and personal history of allergic rhinitis, eczema, and or asthma.

Though allergies are more common in children, it can happen at any age. Allergies can resolve over time, and recur many years later.

How do I know I have Allergies?

Allergies affect various organs of our body.

In the skin, one commonly presents with itchy, red swelling particularly over the gravity dependent region such as the mouth, lips, eyes, and may have rashes that appear nettled-like (hives) or eczema.

In the respiratory tract, one can develop sneezing, itchy runny nose, cough, wheezing or even breathlessness.

In the gastrointestinal tract, one can develop symptoms such as nausea, vomiting, abdominal pain, cramps or diarrhea.

In severe conditions, one may develop a full blown allergic reaction that potentially be dangerous. One may present with acute difficulty in breathing, wheezing, throat swelling, lip and mouth swelling, eyes swelling, rashes and a drop in blood pressure. This tends to occur within minutes to hours after exposure to allergen. This condition is known as anaphylaxis. You should seek medical assistance immediately in such dire situation, and it is advisable to carry emergency adrenalin pen for standby use.

How can I Treat Allergies?

Often, identifying and avoiding offending allergens that causes allergic symptoms are effective. Having said that, there are times when allergens are unavoidable as part and parcel of our lives. The use of medical therapies and having an emergency action plan for severe allergic reactions are important.

Medications that are useful against allergies include antihistamines, decongestions and corticosteroids. These medications are used to alleviate allergic symptoms.

Immunotherapy is a preventive strategy for certain types of allergies. It works by allowing your body to be acclimatized and de-sensitized towards an allergy. This is performed by gradual introduction of allergic substance in an increasing dose into a person via oral, sublingual (under-tongue tablets or spray) or injection shots. Immunotherapy is particularly useful in allergies against dust mites, certain insect stings allergies, grass pollens.

Speak to your doctor if you have concerns of allergies!

The post What Are Allergies? first appeared on Ear & Allergy Clinic Singapore.

Skin Allergies

admin — Wed, 15 Jan 2020 00:21:43 +0000

Sublingual Immunotherapy

Sublingual Immunotherapy (SLIT) is an effective and safe form of allergy therapy that targets a particular allergen, modifying the body’s immune system, allowing it to adapt and de-sensitized against the allergen. It is useful in allergic respiratory diseases such as allergic rhinitis and asthma. The medication is administered beneath the tongue.

Why Should I consider Sublingual Immunotherapy (SLIT)?

It is relatively safe and effective in reducing or even treating allergy.
It reduces long term allergy medication burden.
It is easy to use, can be self-administered at home.
It reduces the risk of acquiring asthma.

SLIT Spray

This is a type of sublingual Immunotherapy that can be administered via a spray underneath the tongue. It comes in a vial with a spray nozzle containing extracts from particular allergens.

How to Use the SLIT Spray?

Hold the spray with your dominant hand.
Raise your tongue and direct the nozzle spray underneath your tongue.
Repeat the procedure daily.

Do I Need to Stop Other Allergy Medications when I am on Sublingual Immunotherapy?

You do not usually need to stop your other medications for allergy treatment. However, over time, you may need less of your medications as the sublingual immunotherapy has effectively reduce your allergy symptoms.

If you are concerned of any medications interacting with sublingual immunotherapy, you can speak to your doctor.

How long do I need to use the SLIT Spray? Can I abort the treatment before the recommended time frame?

The recommended duration of treatment is 3-5 years. In the event of you stopping the treatment before 3 years, the effectivity of allergy improvement may not sustain over time.

Where should I store my SLIT Spray?

You are advised to keep the spray in the refrigerator at a temperature of 2-8C. Having said that, the spay is safe and stable at a temperature below 25C.

Any Travelling Tips?

It is relatively hassle-free. Check with your airlines, as passengers are usually allowed to hand carry when travel by air, and stored it in a small bag with an ice pack.

Is there are other options of Sublingual Immunotherapy?

Yes, speak to your doctor for other options

The post Skin Allergies first appeared on Ear & Allergy Clinic Singapore.

Insect Allergies

admin — Wed, 15 Jan 2020 00:19:52 +0000

Allergy Testing

Allergy Testing is offered to detect specific allergens. By identifying the culprit allergens, they can be avoided to preventing future allergic reactions or undergo Immunotherapy as part of the treatment. Allergy testing can be performed via blood tests or skin prick test.

Which Allergy Test is Suitable for Me?

Speak to your doctor on your individual concerns and allergy conditions. Your doctor will discuss in detail with you on the pros and cons of each tests before advise further.

Allergy Blood Test

This is a blood-taking procedure performed via your trained doctor or phlebotomist. The allergy blood test detects specific IgE antibodies produced against specific allergens. There are a wide range of allergen panels that can be tested through IgE antibodies blood tests.

Skin Prick Test

This is a relatively simple, and accurate way of detecting an allergy. Skin Prick Test is a procedure performed over the arm of a person. It involves marking of the tested skin area, following the introduction of allergens into the skin. The test is later interpreted by your doctor for any evidence of allergic reaction.

How long can I get my allergy test results

Allergy blood test

It takes approximately 1-2 weeks for the results to be ready after laboratory processing.

Skin prick test

This procedure takes approximately 20-30 minutes and You will be able to obtain a copy of the results on the same day.

What are the Common Side Effects is Skin Prick Test?

The test is offered in clinic setting with close monitoring from your health care providers.

Most people tolerated the procedure well with minimal pain and without any bleeding, though some may experience mild itch and redness over tested skin area.

Severe reaction to skin prick test is uncommon.

Do I Need to Stop my Allergy Medicine or other Long Term Medicine for Allergy Testing?

Some allergic medications (such as antihistamine- piriton, cetirizine, loratadine etc) can affect skin prick test results. Long term medications such as antidepressants may interfere the results as well. Please inform your doctor on all the medications that you are consuming.

How Accurate and Reliable is Allergy Testing?

When Skin Prick Test is performed correctly, it is relatively reliable. However, you may have a negative skin prick test, yet develop allergy later on in life. This is known as false negative. This might happen due to:

Your body may develop new allergy over time due to repetitive exposure to the allergens.
You may be consuming certain medications that lead to a false negative result.
Physician variability- Skin prick test is performed by doctors with invariably slight deviation in their methods and skills.

The Allergy Blood Test has the edge of having a test result that is not interfered by medicine that the person is taking. However, there is a chance of false positive and This may cause unnecessary confusion and anxiety to patients.