Immunotherapy treatment recommendations

 

In patients with subcutaneous immunotherapy, it is important that treatment is properly controlled by specialist health staff.

Generally, itching and swelling of the area of application are the most common reactions, either with subcutaneous or sublingual immunotherapy.

The most serious reactions are uncommon and usually occur in the first minutes after subcutaneous administration. For this reason it is recommended to stay at least 30 minutes under observation at the center where the vaccine is administered.

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For safe administration of immunotherapy and to attend an eventual adverse reaction, the center that administers immunotherapy should have available:

  • Adrenalin 1/1000.
  • Short-acting bronchodilators (parenteral and inhaler).
  • 1st generation antihistamines (oral and parenteral).
  • Corticosteroids (parenteral).
  • Oxygen therapy.
  • Compressors, syringes, hypodermic needles, large gauge needles and mechanisms of canalisation of venous systems.

 

Control of treatment by the patient:

  • Stage of completion of the prescribed medication.
  • Using immunotherapy contraindicated drugs such as blockers (atenolol, etc.) orally or parenterally or in eye drops to treat glaucoma, etc.
  • If you have new contraindication to the administration of adrenaline due to: poorly controlled hypertension HTN, heart disease, hyperthyroidism, glaucoma. (Check with your doctor)

 

Control of the physical condition of the patient:

  • Presence of bronchial symptoms (cough, asthma, etc.)
  • Presence of febrile infectious disease (respiratory infection, runny nose, fever, viral infections, rash illness in children, active TB, hepatitis …) Delaying one week administration of immunotherapy in cases of respiratory infection, fever, an infectious process, unstable asthma or if the peak flow is 20% less than their usual baseline).
  • If you have received in recent days a live virus vaccine (MMR, Rubella, Varicella, Influenza Virus Integer, etc.). Delay the administration of the extract if you received a live vaccine within 10 days.
  • Measurement, if applicable, of the peak expiratory flow (PEF) if you have asthma.
  • Pregnancy: Do not start immunotherapy treatment in pregnant patients. Once on the maintenance dose you should continue the treatment. If in doubt, consult an allergist.

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Dose administration:

  • Wash hands.
  • Ask tolerance level of previous dose of the vaccine.
  • Check the vaccine corresponds to the patient and the expiry date.
  • Select the appropriate vial, gently shake it and extract the correct dose with a disposable 1- ml syringe, calibrated in mls.
  • Confirm that the vial and dose are correct.
  • It is recommended to alternate arms in the respective administrations.

 

Procedures for administering:

  • Disinfect the top of the vial and skin area where the extract will be administered.
  • Subcutaneous route: pinch skin using your thumb and index finger, insert needle into skin with the bevel facing upwards, at an angle of 45 ° on the outer arm at the midpoint between shoulder and elbow in the same line from the elbow.
  • Loosen the skin, breathe in slowly to make sure the needle is not in a blood vessel, if this happens, remove the needle and repeat the whole process. If the volume to be injected is high, the extraction should be repeated.
  • Slowly administer therapy (the slower the less local reaction). After the thumb button plunge is fully depressed, wait 5 seconds before withdrawing the needle to prevent reflux of the extract.
  • After injection, gently press the point of application with cotton wool, do not rub or massage the area.
  • Dispose of the material used safely in accordance with organic waste material rules.
  • Do not recap needle to avoid risk of accidental pricking.

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After administration of the dose:

  • Always make a note of the date of the dose, the amount administered, route and arm where it was applied.
  • Indicate the date of the next dose.
  • The patient must be at least 30 minutes at the hospital for reassessment and to address possible adverse effects. After this time the patient should go back to the consulting room.

 

Advice to patient:

  • Avoid physical exercise, sauna or hot baths for 3 hours after administration.
  • You can shower.
  • Avoid scratching the skin. Where local reactions occur, apply localised cold and consult with your healthcare professional.

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Allergy recommendations index.

 

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