Allergies

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Notes

The Guidelines section will contain only the 2006 published guidelines. To view Guidelines from previous years, view year 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).

Allergies

Daily Treatment Report

In this Report:

Cognitive Therapy-CBT-Psychotherapy
Device Therapy
Drug Side-Effects and Interactions
Drugs
Exercise
General Information
Guidelines
Immunotherapy
Internet Sites
Nutrition
Other
Radiotherapy
Supplements-Vitamins-CAM
Surgery

Cognitive Therapy-CBT-Psychotherapy

Device Therapy

Drug Side-Effects and Interactions

The safety of tacrolimus ointment for the treatment of atopic dermatitis: a review. (Br J Dermatol. 2007)

Anaphylactic reactions during immunotherapy. (Immunol Allergy Clin North Am. 2007)

Drugs

Food-induced anaphylaxis and repeated epinephrine treatments. (Ann Allergy Asthma Immunol. 2007) “CONCLUSIONS: Of patients presenting to the ED with food-induced anaphylaxis, approximately 16% were treated with 2 doses of epinephrine. This study supports the recommendation that patients at risk for food-induced anaphylaxis carry 2 doses of epinephrine. Further study is needed to confirm these results and to expand them to patients who do not present to the ED because that group may have a lower frequency of epinephrine use.”

[Anaphylaxis in two children caused by peanut and nut allergies; recommendations for treatment] (Ned Tijdschr Geneeskd. 2007) "The most important therapeutic intervention is the intramuscular administration of epinephrine. For patients with two or more risk factors the prescription of an epinephrine auto-injector should be considered."

Exercise

General Information

Eczema baths 'a waste of money' "Bath products to help ease the skin inflammation caused by allergic eczema may not be worth the amount of money the NHS spends on them, a study says. There is no clinical evidence these emollients work, nor any consensus of medical opinion, researchers writing in Drug and Therapeutics Bulletin contend. "

Comparison of international guidelines for the emergency medical management of anaphylaxis (Allergy 2007) "As is clear from inspecting the table, while all agree on the central role of adrenaline, there is however, no clear agreement on the role of other commonly used first-line approaches and agents. There are thus important differences in recommendations regarding posture, use of adrenaline, corticosteroids, H1- and H2-antihistamines, oxygen and bronchodilators."

H1-antihistamines for the treatment of anaphylaxis: Cochrane systematic review (Allergy 2007) "Anaphylaxis is under-recognized and under-diagnosed, both in those who survive and those who die. Half of all of those who do not survive an episode of anaphylaxis have no indicative findings at autopsy (8). Individuals aged >30 years are more likely to experience hypotensive anaphylaxis (16), and are thus at greatest risk of death from insect sting anaphylaxis, with cardiovascular collapse usually a prominent feature (8). In comparison, people who die from food-induced anaphylaxis tend to be younger, and fatality is predominantly due to upper and/or lower airway obstruction; moreover, poorly controlled asthma appears to be a major risk factor for death (8, 12, 17)."

Evidence-based management of anaphylaxis

Treatment of anaphylaxis in adults: results of a survey of doctors at Dunedin Hospital, New Zealand. (N Z Med J. 2007)

Treatment Options for Atopic Dermatitis (Am Fam Physician 2007) "Atopic dermatitis is the most common childhood skin disorder in developed countries.1 The prevalence of atopic dermatitis has increased two- to threefold in the last three decades, affecting 15 to 20 percent of young children.2 Clinical findings of atopic dermatitis are variable but can be categorized into three groups of diagnostic features: essential, important, and associated (Table 1). … Topical corticosteroids have been the mainstay of treatment for atopic dermatitis flare-ups and are the agents to which other treatments are compared"

Guidelines

AAP Releases Guidelines on Treatment of Anaphylaxis "Epinephrine is an effective treatment option for anaphylaxis if it is injected into the lateral leg immediately. Delayed injection is associated with poor outcomes and may cause death. Persons who require additional care after the administration of epinephrine should seek immediate medical attention. The American Academy of Pediatrics (AAP) recommends a lateral thigh epinephrine injection of 0.01 mg per kg, but no more than 0.30 mg per kg, for children with anaphylaxis. Administering the epinephrine intravenously increases the risk of dosing and dilution errors, and it also can increase the patient's risk of cardiac dysrhythmia."

Self-injectable Epinephrine for First-Aid Management of Anaphylaxis (PEDIATRICS 2007)