1. PATIENTS SHOULD REMAIN IN THE WAITING AREA FOR AT LEAST 30 MINUTES AFTER EACH SHOT.

2. In the course of building up your allergy injections to a maintenance dose, it is possible that a reaction may occur. If the reaction occurs following the first or second shot, it may be necessary to begin treatment with a weaker extract. A reaction occurring during the build-up period may indicate the maximum tolerated dose has been reached.

3. In addition, any stimulus which causes a speeding up of the circulation may cause too rapid an absorption of the allergy vaccine and cause a reaction. Examples would be exercise, hot and muggy weather, pregnancy and anxiety. Therefore, you should not partake in heavy exercise for two hours before and after the infections, especially on hot summer days. Injections may be continued during pregnancy, but the dose may have to be reduced. Please notify the nurse or doctor as soon as you know that you are pregnant.

4. Reactions which should be brought to the attention of the nurse or doctor IMMEDIATELY include the following:
   1. Sensation of warmth followed by generalized itching or hives.
   2. Sensation of tightness or itching in throat, tongue, roof of mouth, chest, etc.
   3. Itching in nose, sneezing, nasal stuffiness and eye symptoms.
   4. Local reactions at site of the injection which last more than 24 hours, regardless of the size of the reaction.

   If you experience any of these symptoms you should report this immediately to the nurse or doctor. (THE MOST DANGEROUS REACTIONS OCCUR WITHIN MINUTES AFTER THE INJECTION, AND THIS IS THE REASON FOR THE MINIMUM WAITING PERIOD OF 30 MINUTES.)

5. Because Beta-Blocker medications can cause allergic reactions to be more severe and prolonged, it is absolutely necessary that all patients currently taking Beta-Blockers and receiving allergy infections notify us immediately.

6. If any of the above symptoms occur after you leave the office, report at once to the Emergency Room or the office, whichever is closer.

7. Reactions occurring later than one hour after the injection can be treated at home, if not too severe. If the reaction consists of wheezing or tightness of the chest, a bronchodilator (e.g., Albuterol) may be taken. If the symptoms are primarily itching or sneezing, then an antihistamine such as Benadryl, Actifed, Dimetapp or Chlor-Trimeton should be taken. Symptoms starting more than 24 hours after the injection are probably not related to the injection.

8. One of the most common reasons for reactions to injections is failure to receive them on a regular basis. As a general rule, the injection dose can be increased when given weekly. The same dose may be repeated up to four weeks later. If the interval between injections is greater than four weeks, the dose will most likely be reduced.

I HAVE READ THE ABOVE INFORMATION AND UNDERSTAND THAT I AM TO REMAIN IN THE WAITING AREA FOR 30 MINUTES FOLLOWING MY ALLERGY INJECTIONS.

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If you are taking one of the Beta-Blockers listed below and are currently receiving immunotherapy (allergy injections) contact a doctor or nurse immediately. Our office needs to know if you are taking a Beta-Blocker medicine because in the event you experience a generalized reaction (especially wheezing, severe hives or swelling in the throat after an injection), Beta-Blockers can interfere with your body's response to treatment (you may require larger doses of adrenal in or epinephrine to reverse the reaction). It is therefore absolutely necessary that all patients currently receiving allergy injections and currently taking Beta-Blockers notify us immediately.

Beta-Blockers:*

Acebutolol (Sectral)

Atenolol (Tenormin, Tenoretic)

Betaxolol (Kerlone)

Bisoprolol (Zebeta, Ziac)

Carteolol (Cartrol)

Carvedilol (Coreg)

Esmolol (Brevibloc) (IV use only)

Labetatol (Normodyne, Trandate)

Metoprolol (Lopressor, Toprol)

Nadolol (Corgard, Corzide)

Penbutol (Levatol)

Pindolol (Visken)

Propranolol (Inderal, Ineride, Innopran)

Sotalol (Betapace)

Timolol (Blocadren, Timolide, Timoptic eye drops)

*New medications continually appear for treatment. To ensure your safety, you need to keep a complete list of all of your medicines with you at all times, and notify our office when a new medicine is prescribed for your health.

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Michigan Allergy, Sinus & Asthma Specialists

6330 Orchard Lake Road #110 West Bloomfield, MI 48322 Tel: 248.932.0082 Fax: 248.932.0182 view map

37595 Seven Mile Road #320 Livonia, MI 48152 Tel: 800.739.6100 Fax: 248.932.0182 view map

Web: www.michiganallergy.com
Web: www.michiganfoodallergy.net
Email: miallergy@comcast.net

Please do not email confidential medical information.