Presentation on theme: "SIRCPPK309 Assist customers seeking to relieve common allergic symptom reactions."— Presentation transcript:
1 SIRCPPK309Assist customers seeking to relieve common allergic symptom reactions
2 SIRCPPK309 Unit Descriptor This unit describes the performance outcomes, skills and knowledge required to assess customer needs, select and supply relevant products, and advise on self-care practices to relieve common allergic symptom reactions.
3 AllergyAllergies are very common and increasing in Australia and New Zealand, affecting around one in three people at some time in their lives.There are many different causes of allergy and symptoms and vary from mild to potentially life threatening.
4 AllergyAllergy is also one of the major factors associated with the cause and persistence of asthma.However, the good news is that for most allergies, effective prevention and treatment options are available.
5 AllergyAllergy occurs when a person's immune system reacts to substances in the environment that are harmless for most people.These substances are known as allergens and are found in house dust mites, pets, pollen, insects, moulds, foods and some medicines.
6 AllergyAtopy is the genetic (inherited) tendency to develop allergic diseases.People with atopy are said to be atopic.When atopic people are exposed to allergens they can develop an immune reaction that leads to allergic inflammation (redness and swelling).
7 Pathophysiology What happens when you have an allergic reaction? When your body comes into contact with an allergen, it sets off a chain of events within your cells. Your immune system starts to produce highly specific IgE (immunoglobulin E) which binds to a type of white blood cell called a mast cell. When IgE binds to a mast cell, it causes the mast cell to become activated. Upon activation, the mast cell will release histamine and various other mediators.
11 Allergy Causes of allergic reactions Dust mites Pollen Foods such as peanuts, cow's milk, soy, seafood and eggsCats and other furry or hairy animals such as dogs, horses, rabbits and guinea pigsInsect stingsMouldsSome medicines
12 AllergySimilar reactions can occur to some chemicals and food additives, however if they do not involve the immune system, they are known as "adverse reactions" rather than "allergy".
13 Allergy Which areas of the body can be affected? Depending on the allergen and where it enters your body, you may experience different symptoms.For example, pollen, when breathed in through the nose, usually causes symptoms in the nose, eyes, sinuses and throat (allergic rhinitis).
14 AllergyAllergy to foods usually causes stomach or bowel problems, and may cause hives (urticaria). Allergic reactions can also involve several parts of the body at the same time.
15 Allergy Which areas of the body can be affected? The nose, eyes, sinuses and throatWhen allergens are breathed in, the release of histamine causes the lining of your nose to produce lots of mucus and to become swollen and inflamed. It causes your nose to run and itch and violent sneezing may occur. Your eyes may also start to water and you may get a sore throat.
16 Allergy The lungs and chest Asthma can sometimes be triggered during an allergic reaction. When an allergen is breathed in, the lining of the passages in the lungs swells and makes breathing difficult. Not all asthma is caused by allergy, but in many cases allergy plays a part.
17 Allergy The stomach and bowel Most stomach upsets are caused by richness or spiciness in the food itself, rather than an actual allergy. However, foods which are most commonly associated with allergy include peanuts, seafood, dairy products and eggs.
18 AllergyCow's milk allergy in infants may occur and can cause eczema, asthma, colic and stomach upset. It may also lead to failure to thrive. Some people cannot digest lactose (milk sugar). This intolerance to lactose also causes stomach upsets, but must not be confused with allergy.
19 Allergy Which areas of the body can be affected? The skin Skin problems such as eczema (dry, red, itchy skin) and urticaria (also known as hives) often occur. Hives are white itchy bumps which look and feel like insect bites. Food may be a factor in some cases of hives and eczema
20 AllergyLife threatening allergic reactions require immediate treatmentMost allergic reactions are mild to moderate, and do not cause major problems, even though for many people they may be a source of extreme irritation and discomfort.However, a small number of people may experience a severe allergic reaction called anaphylaxis.
21 AllergyIt is a serious condition which requires immediate life-saving medication.Some of the more frequent allergens which may cause this are peanuts, insect stings, drugs and shellfish.If you know that you have a very severe allergy, you should have an Anaphylaxis Management Plan from your doctor, which should include an ASCIA Action Plan for Anaphylaxis
22 Allergy Effective treatment and prevention options Allergen avoidance (or reduction) relies on identifying the cause of your allergy and then taking steps to reduce your exposure to the allergen. For instance, many people are allergic to dust mites, therefore reducing dust mite in the house is important.
23 AllergyAvoiding known allergic triggers is an important part of allergy and asthma management. Allergy testing using skin prick tests or blood tests for allergen specific IgE (RAST) helps your doctor to confirm which allergens you are sensitive to, so that appropriate avoidance advice can be given.
24 Allergy Which allergens should be tested for? Allergy testing is usually performed in people with suspected allergic rhinitis (hay fever), asthma or reactions to insects or food allergy. In people with allergic rhinitis or asthma, allergy testing usually includes house dust mite, cat and dog dander (perhaps other animals if contact occurs), mould spores, pollen from relevant grasses, weeds or trees and in some cases, occupational allergens. Testing can also be used to confirm suspected allergies to foods or stinging insects.
25 Allergy It is important to note that: Allergy test results cannot be used on their own and must be considered together with previous and current medical historyMedicare rebates are available for skin prick tests or blood tests for allergen specific in AustraliaIn some cases, you may be referred to a medical specialist (Allergist / Clinical Immunologist) for further detailed assessment.
26 Allergy Which allergens should be tested for? It is important to note that:Allergy test results cannot be used on their own and must be considered together with your medical history
27 AllergyMedicare rebates are available for skin prick tests or blood tests for allergen specific in AustraliaIn some cases, you may be referred to a medical specialist (Allergist / Clinical Immunologist) for further detailed assessment.
28 Allergy Skin prick tests Skin prick testing is the most convenient and least expensive method of allergy testing. As results are available within 20 minutes, this allows you to discuss the results with your doctor at the time of testing. Skin prick testing has been shown to improve the accuracy of diagnosis in published clinical studies.
29 AllergySkin prick testing is most commonly performed on the forearm, although the back is sometimes used. The arm is first cleaned with alcohol. A drop of commercially produced allergen extract is placed onto a marked area of skin. Using a sterile lancet, a small prick through the drop is made. This allows a small amount of allergen to enter the skin.
30 AllergyIf you are allergic to the tested allergen, a small lump (wheal) will appear at the site of testing over minutes.
32 AllergySkin prick tests are slightly uncomfortable, but are usually well tolerated, even by small children. Local itch and swelling normally subside within 1-2 hours. More prolonged or severe swelling may be treated with an oral antihistamine, topical corticosteroid cream and an ice pack. Occasionally people will experience feel dizzy or light-headed and need to lie down. Severe allergic reactions from allergy testing in asthma or allergic rhinitis (hay fever) are very rare.
33 AllergySkin prick testing should only be performed by a health professional who has been trained in the procedure, and who knows how to interpret the results. A doctor with knowledge of the management of acute allergic reactions should be present, to select the allergens, interpret the results and have access to resuscitation facilities in the case of an emergency.
34 AllergySkin prick testing should only be performed by a health professional who has been trained in the procedure, and who knows how to interpret the results. A doctor with knowledge of the management of acute allergic reactions should be present, to select the allergens, interpret the results and have access to resuscitation facilities in the case of an emergency.
35 AllergyMedications with antihistamine like actions (such as antihistamine tablets, some cold remedies and antidepressants) should not be taken for 3-7 days before testing as these will interfere with the results of testing. You may also be advised to avoid creams and moisturisers on your forearms for a similar period of time to reduce the likelihood that allergen extracts will run into each other.
36 AllergySkin prick testing is not a reliable way of confirming suspected reactions to aspirin or food additives, and you will need to discuss such concerns with your doctor.
37 AllergyPatch TestingPatch testing is useful for testing for contact allergic dermatitis, such as that triggered by nickel metal, cosmetic preservatives or various plants.Using hypoallergenic tape, commercial standardised allergen paste is applied to a rash free area of skin, most commonly the back.
38 AllergyThe tapes are normally left in place for 48 hours and kept dry for the entire time.The test site is then read at different time intervals.An eczema-like rash can indicate sensitivity to a particular allergen.
41 Allergy Alternative skin testing methods Alternative skin testing methods such as scratch testing have generally been abandoned because of greater patient discomfort.Whilst it is not widely used in Australia and New Zealand, intradermal skin testing is sometimes used to test for allergies to antibiotic drugs or stinging insects, when greater sensitivity is needed.
42 Allergy Blood tests for specific allergy Immunoglobulin E (IgE) antibodies directed against specific allergens can be measured with a blood test, commonly referred to as RAST tests. RAST was the abbreviation for the original name of the technology (RadioAllergoSorbent Test).
43 AllergyThese tests are often performed when skin testing is not easily available, when skin conditions such as severe eczema exist, or when a person is taking medications (such as antihistamines) that interfere with accurate testing
44 Allergy Total IgE Testing Meaurement of total IgE antibodies can be estimated from a blood sample.Total IgE is often, but not always raised in people with allergies.High IgE antibody levels are also found in people with parasite infections, eczema and some rare conditions.
45 AllergyHigh IgE levels do not prove that symptoms are due to allergy, and a normal IgE level does not exclude allergy.Therefore, measuring total IgE levels has a limited role to play in allergy testing.
46 Allergy Eosinophil counts Eosinophils are specialised white blood cells that are designed to kill worms and parasites.They can also cause inflammation in the tissues in allergy.High levels are sometimes seen in blood samples from people with allergic rhinitis (hay fever), asthma and eczema, as well as in a number of less common conditions.
47 AllergyHowever, a high eosinophil count does not prove that symptoms are due to allergy, and a normal eosinophil count does not exclude allergy.Therefore measuring eosinophil counts has a limited role to play in allergy testing.
48 Allergy Unproven Methods There are several methods that claim to test for allergy.These include cytotoxic food testing, kinesiology, Vega testing, electro dermal testing, pulse testing, reflexology and hair analysis.
49 AllergyThese tests have not been scientifically validated and may lead you to take unnecessary, costly and (in the case of some changes in diet) dangerous avoidance strategies.No Medicare rebate is available in Australia for these tests and the use of these methods is not advised
50 Allergy Allergy Avoidance Allergies are very common in Australia and New Zealand, affecting around one in three people at some time in their lives. There are many different allergic conditions, with symptoms ranging from mild hay fever (allergic rhinitis) to potentially life threatening anaphylaxis. Allergy is also one of the major factors associated with the cause and persistence of asthma.
51 AllergyIdentifying causes which you can avoid or minimise exposure to, is an essential part of treating allergic diseases. Once the causes are correctly identified, then the following practical advice on avoiding or minimizing your exposure to allergens should help.
53 Allergy House Dust Mites The house dust mite is the most common allergen source in humid towns and cities and there is no easy way of removing it.Regardless of what advertisements may say, there is no vacuum cleaner, dust mite spray or dry cleaning that will completely eliminate the dust mite.
54 AllergyHouse dust mites can trigger respiratory or dermatological conditions including asthma and eczema. Symptoms can include:WheezingCoughingBreathlessnessA tight feeling in the chestRunny nose
55 Allergy Itchy nose Itchy eyes Itchy skin Skin rashes The allergic reaction Unlike other common household bugs (fleas, for example), dust mites don’t bite. Their bodies, secretions and faeces contain particular proteins that can trigger allergic symptoms in susceptible people
56 AllergyCommon hiding spots The diet of the house dust mite includes shed skin flakes, pollen and fungal spores. It prefers warm, humid and dark environments. Common hiding spots around the home include: Mattresses and bed linenUpholstered furnitureShag-pile or long-fibred carpetsSoft toys.
57 AllergyDiagnosis and treatment for dust mite allergies Allergy testing can find out whether house dust mites trigger your respiratory or dermatological symptoms. See your doctor for further information and advice.
58 AllergyIf tests show that you are allergic to house dust mites, there are ways to reduce your immune system response. For example, you could undergo immunotherapy, which involves deliberately exposing you to dust mite extracts to ‘train’ your immune system not to overreact. Measures designed to reduce your household’s dust mite population may also be helpful.
59 AllergySelf careDepending on the severity of symptoms, and in the case of childhood asthma, eczema, chronic or recurrent sinusitis and middle ear infections with dust mite as a provoking trigger, the following advice may help.The first room to tackle is the bedroom and in particular the bedding, where we spend the greatest number of consecutive hours.
60 Allergy A combination of the following 4 measures is recommended: Wash sheets and pillow cases weekly in water hotter than 55oC.This will kill dust mites and wash away the allergen they produce.If you cannot wash in hot water, use a commercial product containing essential oils such as tea tree or eucalyptus oils, formulated to kill dust mites in cold water.
61 AllergyIf washing normally, hot tumble drying of washed items for 10 minutes after they are dry will kill mites.Dry cleaning is not as effective as it will kill house dust mites but won't remove the allergen they produce.
62 Allergy Remove sheepskin or woolen underlays. Remove all soft toys from the bed and bedroom. Replace them with wooden or plastic toys which can be washed. If a soft toy is allowed it should be hot washed weekly. Freezing soft toys overnight kills mites but doesn't remove allergen.
63 AllergyThe following advice can be applied to bedrooms and other rooms of the houseIf possible, consider replacing carpets with hard floors such as wood, tiles, linoleum, concrete, where practical and affordable. Carpets can contain large amounts of house dust mite and animal allergens which cannot be completely removed by vacuuming. In general, dust mite levels are higher in more humid areas like the coast than in drier inland areas.
64 AllergyVacuum carpets weekly. However, vacuuming increases the amount of house dust mite allergen in the air for up to 20 minutes. So if possible, ask someone else to do the vacuuming and wait for 20 minutes before re-entering the room. High efficiency particulate air (HEPA) filter vacuum cleaners may remove more allergen than other vacuum cleaners. Unfortunately, they still temporarily increase the amount of dust mite allergen in the air.
65 AllergyReduce humidity - Have a dry and well ventilated house, adequate floor and wall insulation. Avoid using evaporative coolers (water cooled air conditioners) and gas heaters, as these both release water into the air and can increase indoor dust mite and mould levels.Windows - Venetian blinds or flat blinds are easier to clean than heavy curtains. Washable curtains or external shutters are other options.
66 House Dust mites Companion Products Cover mattress, pillow and quilt with dust mite resistant covers. Suppliers include Allergend, Allerseach and Mite guard. Some health funds may provide a rebate for the purchase of these items. The covers must be washed every 2 months. If covers are not available, wash blankets and non-encased washable doonas every 3 months in hot water.
67 AllergyConsider house dust mite avoidance measures when building a new home.Damp dust or use electrostatic cloths to clean hard surfaces (including hard floors) weekly.
68 Pollen AllergyIn Australia and New Zealand the height of the grass pollen season occurs between late September and Christmas and the major amount of pollen in the air usually occurs between 6.00 am and noon. Depending on the weather patterns, there may be an increase of pollen in the early hours of the morning.
69 Pollen AllergyAlthough pollen is known to be blown long distances on windy days, most pollen is deposited within a short distance of its source. The highest pollen counts occur on calm, hot, sunny days in late October, November and December, although in Queensland the season is different and January is a particularly bad month.
70 Pollen AllergyPollen allergy in tropical areas mainly occurs during the dry season. However, thunderstorms can also cause problems. When pollen granules come into contact with water, starch granules are released that are small enough to be breathed into the airways, triggering hay fever (allergic rhinitis) and asthma in some people.
71 Pollen AllergyAvoidance of pollen is difficult but the following advice may help:Remain indoors (when possible) during pollen seasons, on windy days or after thunderstormsAvoid activities known to cause exposure to pollen, such as mowing grass
72 Pollen AllergyShower after activities where there is high exposure to pollenUse re-circulated air in the car when pollen levels are highSeek advice from your pharmacist or doctor about medications or treatments that will relieve your symptoms.
73 Pollen AllergyPollen from grasses, weeds or trees can trigger symptoms of allergic rhinitis (hay fever) and asthma. Pollen seasons can last for several months and exposure is difficult to avoid. However, there are simple ways to prevent or reduce symptoms.
74 Pollen Allergy What is pollen? The word pollen is derived from the Greek word meaning 'fine flour'. The role of the pollen grain is to fertilise the female flower to reproduce plant species.Some plants (such as flowering plants, including wattle) produce small amounts of pollen which are distributed by birds and bees from one plant to another.
75 Pollen AllergyOther plants (such as pasture grasses and weeds) rely on the wind to disperse their pollen. These pollen are produced in vast quantities, blow long distances and cause allergies in people, even if they live a long way from the source
76 Pollen AllergyMost of the troublesome pollen is produced by airborne Northern Hemisphere grass, tree and weed pollen. Improved pasture grasses are more allergenic than Australian native grasses. Pollen from exotic trees, which are planted for their autumn colours, is more allergenic than pollen from Australian trees.
77 Pollen AllergyA number of weeds with highly allergenic pollen have also been introduced, including:Pellitory weed (commonly known as 'asthma weed') was accidentally introduced in a shipload of marble from Italy in the early 1900s. It is mainly found in Sydney.
78 Pollen AllergyPaterson's Curse (Echium plantagineum) is an attractive flowering plant that was deliberately brought from England in the late 1800's by Dr Paterson. This plant has taken over large tracts of pasture in rural Australia and produces highly allergenic pollen.
79 Pollen AllergyRagweed and Parthenium weed were introduced in pasture seed imported from the United States. They have spread throughout Queensland and northern New South Wales.
80 HayfeverThe correct name for hay fever is 'seasonal allergic rhinitis'.Even though it was known that pollen rather than hay was the cause as far back as the early 1800's, the term 'hay fever' is still frequently used.
81 HayfeverHay fever is the common name for a condition called allergic rhinitis, which means an allergy that affects the nose. Most people associate hay fever with spring, when airborne pollens from grasses are at their peak. However, hay fever can occur at any time of the year. This is known as perennial allergic rhinitis, which is usually caused by a reaction to allergens around the home, such as dust mites, moulds or animal hair or fur.
85 Hayfever Refer to the pharmacist if the customer: Is pregnant or breastfeedingIs experiencing high temperatures, severe body aches and pains, thick green mucosal discharge and or sinus painIs taking other medicationsHas a medical condition
86 Hayfever Is elderly (over 70yrs ) or very young (under 12months) Is allergic to any medicines, supplements or foodWears contact lenses – when recommending eye dropsHas tried ‘everything’ but nothing works
87 HayfeverTreatmentLess-sedating antihistamines These are medicines which inhibit the action of histamine in the body therefore eliminating the symptoms of hay fever and allergy. These are usually non-drowsy although some people may experience drowsiness with taking some medications in this class (particularly with Zyrtec).
90 HayfeverAdvise customers to avoid driving or operating machinery if this occurs. Less-sedating antihistamines are Schedule 2 – pharmacy medicine and can be purchased over the counter. (For example, Telfast, Zyrtec and Claratyne)
91 HayfeverSedating antihistamines These are medicines which inhibit the action of histamine in the body therefore eliminating the symptoms of hay fever and allergy. As these are of an older generation of medicines, they will usually cause drowsiness and can also affect the rate of learning in children
92 HayfeverMany sedating antihistamines are in Schedule 3 (Pharmacist Only Medicine) therefore it is necessary to get the pharmacist’s advice before recommending and selling these products. (For example, Polaramine, Phenergan)
93 Nasal Sprays The different types of nasal sprays Decongestant nasal spraysAntihistamine nasal spraysCorticosteroid nasal sprays
94 HayfeverDecongestants These products can come in the form of tablets, nasal sprays and eye drops. They work to constrict the blood vessels supplying the area (for example in the eye for eye drops, in the nose for nasal sprays) and therefore reducing congestion.
95 Topical Decongestant Sprays Xylometazoline 1mg/mlContains Benzalkonium chloride as a preservative
96 Topical Decongestant Sprays Acts quickly to relieve a blocked or runny nose caused by colds,flu,sinusitis or hay fever It works by narrowing the blood vessels in the nose area, reducing swelling and congestion Caution: Temporary stinging sensation, sneezing may occur and rebound congestion can occur if used more often than 3 days at a time
101 Topical Corticosteroid Nasal Sprays Features and benefitsConvenient once daily doseHelps treat nasal symptoms of both seasonal (outdoor) and year round (indoor) allergic rhinitis such as sneezing, congestion, itchy and runny nose
102 Topical Corticosteroid Nasal Sprays Regular use helps with overall effectiveness. Maximum treatment benefit is after 1-‐2 weeks regular usePotential side effects:Nose bleeds, infections or nose and throatNon drowsy24 hours relief
103 Topical Corticosteroid Nasal Sprays Directions for useFor Adults and Children 12 years and over:Instil one spray into the affected nostril(s)once daily Use spray around the same time each day.Do not skip days. Regular daily use can keep symptoms under control.
104 Topical Nasal Sprays Flixonase Allergy Nasal Spray (was formerly known as Beconase Allergy24hr spray)Active ingredient: Fluticasone propionate
105 Topical Nasal SpraysFor the short-‐term(3-‐6months)prevention of hayfever and other allergies.Not recommended in pregnancy or breastfeedingConvenient once daily sprayNon drowsyFor adults and children aged 12 and over:Instil two sprays into each nostril once daily, preferably in the morning.
106 Topical Nasal Sprays Side effects: Nosebleed, dryness and irritation in nose or throat
107 HayfeverAlthough these products are rather effective, decongestant sprays and drops should not be used for more than 5 consecutive days. This is because prolonged use of these products (tablet form excluded) can cause ‘rebound’ congestion whereby stopping the use of product earlier than 5 days causes the symptoms to redevelop worse than when they started. (For example, Dimetapp 12 hour nasal spray)
108 HayfeverTopical corticosteroids These products come in the inhaled, intranasal and topical cream form. They have an anti-inflammatory effect and work to subdue the immune response when contact with an allergen occurs. They are very safe and effective for people whose symptoms cannot be controlled by oral antihistamines alone.
109 HayfeverThese are available over the counter and can also be purchased in a higher strength when a prescription from the doctor is presented.(For example Sudafed nasal spray)
110 HayfeverImmunotherapy – some people may benefit from immunotherapy, which exposes a person to increasing amounts of an allergen to improve tolerance and reduce symptoms. This therapy may help hay fever and some cases of asthma, but does not help food allergy. It should only be conducted under medical supervision as exposure to allergens can be dangerous and potentially life threatening
112 What is Rhinocort Hayfever Rhinocort Hay fever is a non-drowsy once daily treatment for the prevention and relief of hay fever.It is an intranasal corticosteroid (INCS) nasal spray with the active ingredient budesonide and is an S2 medicationRhinocort Hay fever contains 32mcg of budesonide per activationAvailable as a 60 dose starter pack or a 120 dose economy pack
113 Rhinocort How does Rhinocort Hay fever Work? INCS are effective medications for controlling the range of hay fever symptoms including sneezing, itching, a runny nose, eye symptoms and nasal blockage.Rhinocort Hayfever works by reducing and controlling the inflammation that causes nasal blockage and other symptoms of hay fever.
114 RhinocortRhinocort Hayfever therefore treats, and when used early enough, can prevent symptoms.Other types of hay fever medicines, such as antihistamines, only treat the symptoms
115 Rhinocort How quickly will Rhinocort Hayfever work? Some symptoms, such as a blocked nose, can start to disappear in 3 hours, however it can take up to 2-3 days for the maximum effect of Rhinocort Hayfever to be achieved.Continuing to take antihistamines during this transition period may offer further relief
116 Rhinocort Take Rhinocort before hay fever starts Taking Rhinocort Hayfever 1-2 weeks before you are exposed to allergens that can trigger your hayfever (for example before the start of the pollen season) can prevent hay fever symptoms from developing.It also prevents the lining of the nose from becoming hyper reactive – extra sensitive to allergens
118 Rhinocort How much Rhinocort should I use? Rhinocort Hayfever should be used daily for the treatment and prevention of hayfever symptoms.The starting dose is up to FOUR sprays in EACH nostril daily (8 sprays). You can take these sprays all in the morning, or TWO sprays in the morning and TWO sprays in the evening
119 Rhinocort Do not exceed the recommended dose of EIGHT sprays per day After the symptoms have improved you should gradually reduce the number of sprays you put into each nostril to the lowest number that controls your symptoms.This might be one spray into each nostril in the morning
120 Rhinocort Stage Dose Treatment 2-4 sprays in each nostril daily Maintenance1-2 sprays in each nostril daily
121 Nasal Sprays How to administer nasal sprays Blow your nose gently to clear out mucus and to create a clear passageway for the nasal spray.Shake the nasal spray bottle and remove the cap.Tilt your head slightly forward.Exhale slowly.
122 Nasal SpraysHold the spray bottle securely in your hand, and insert the end of the pump into your nostril. The tip of the pump should point up and slightly outward, not toward the center of your nose.Use a finger on your free hand to close the other nostril.Breathe in slowly while squeezing the spray pump.Repeat in other nostril.
123 HayfeverSelf CareStay indoors as much as possible in spring, on windy days or after thunderstorms.In the garden, choose plants that are pollinated by birds or insects, rather than plants that release their seeds into the air.Replace the lawn with bricked or paved areas.
124 HayfeverAvoid allergens such as: dust and dust mites, animals and animal hair or fur (dander).Avoid carpet or large area rugs as the fibres hold onto dust, mites, dander and pollen. (Tile and wooden floors are better)Wash bedding frequently to eliminate dust mites getting into mattresses and pillows. Make sure pillows and mattresses are in allergen-impermeable casings
125 HayfeverSmear petroleum jelly (like Vaseline) inside the nose to stop the pollen from touching the lining of the nose.Wear a dust mask when cleaningKeep pets outside of the house and away from bedroomsUse a vacuum cleaner with HEPA (High-efficiency particulate air) filters
126 Hayfever Companion products Cover mattress, pillow and quilt with dust mite resistant coversTissuesSaline spraysHumidifiers
127 Allergic Conjunctivitis The four main types of allergic conjunctivitis are:Seasonal conjunctivitis: typically caused by an allergy to pollenPerennial conjunctivitis: usually caused by an allergy to dust mites or pets
128 Allergic Conjunctivitis Contact dermato conjunctivitis: usually caused by an allergy to eye drops or cosmeticsGiant papillary conjunctivitis: usually caused by an allergy to contact lenses
129 Eye DropsAllergy eye drops are liquid medicines used to treat symptoms of eye allergies. Eye allergy symptoms include:Burning of the eyeFeeling like something is in the eyeItchy eyesRed (bloodshot) eyesSwelling of the eyelidTearing
130 Eye DropsAn eye allergy is linked to the same kinds of triggers that cause hay fever, such as:PollenDustPet danderEye allergies may also be triggered by certain medications or by wearing contact lenses
131 Eye Drops Which type of allergy eye drop you use depends on: The cause of your allergyYour specific symptomsHow much the symptoms affect daily activities
132 Eye DropsNot all allergy eye drops treat all allergy symptoms. For example, an eye drop that relieves red (bloodshot) eyes may not stop the itching.There are many different types of allergy eye drops. Some are sold over the counter while others require a prescription from a doctor. Some relieve symptoms quickly. Others provide long-term relief.
133 Eye Drops The types of allergy eye drops include: Antihistamine Anti-inflammatoryDecongestantMast cell stabilizersMultiple action
134 Eye Drops Antihistamine Allergy Eye drops If you have itchy, watery eyes, antihistamine eye drops may make you feel better. These medicines block histamine buildup in the body.Histamine is a chemical made by your immune system when you come in contact with an allergy trigger. It causes many of your allergy symptoms.
135 Eye DropsAntihistamine eyedrops are usually recommended as the first treatment for eye allergies after you have tried non-drug methods at home.Antihistamine eyedrops can quickly relieve eye allergy symptoms. But relief may only last for a few hours. You may need to use the drops several times a day.
136 Eye Drops Anti-inflammatory Allergy Eye drops Anti-inflammatory eye drops fall into two groups:Non steroidal anti-inflammatory drugs (NSAIDs)Corticosteroids
137 Eye DropsNSAID eyedrops affect certain nerve endings. They change the way your body makes you feel itchy.Acular/Acuvail (ketorolac) is the only NSAID approved for the treatment of itchy eyes. Itching usually starts to go away about one hour after using the eyedrops. These eyedrops often cause stinging or burning when first placed in the eyes.
138 Eye DropsCorticosteroid eyedrops are used to treat severe, long-term eye allergy symptoms. Prescription steroid eyedrops include Alrex and Lotemax (loteprednol).Because of possible side effects, corticosteroid drops are not generally recommended for long-term use, except for the most severe allergic eye conditions.
139 Eye DropsWhen you are using corticosteroid eye drops, you should have regular checkups with an eye specialist to monitor your eye health. Corticosteroid eye drops can raise your risk for:CataractsEye infectionGlaucoma-Increased pressure in the eye (elevated intraocular pressure
140 Eye Drops Decongestant Allergy Eye drops Decongestant eye drops can quickly brighten the whites of your eyes and reduce eye redness for a short amount of time. Such medicines are also called vasoconstrictors. They work by narrowing blood vessels in the eye area. This relieves the red, bloodshot appearance of the eyes.
142 Eye DropsDecongestant eye drops come with some risks. Long-term use can actually make your eye problem worse. "Rebound redness" is a common problem in people who use decongestant drops for a long time. Redness and eye swelling can continue even when you stop using the drops.Decongestant (vasoconstrictor) eyedrops should never be used by people with glaucoma.
143 Eye Drops Mast Cell Stabilizer Allergy Eye drops Mast cell stabilizers are among the newest type of eye drops. They target events in the body that lead to allergy symptoms. The medicine helps prevent the release of histamine and other chemicals made by your body during an allergic reaction.
144 Eye DropsMast cell stabilizers do not provide immediate relief of eye allergy symptoms. Instead, they are used to prevent eye allergy symptoms in people with known allergies, including seasonal allergic conjunctivitis.Customer can use these drops for many months without any side effects. Mast cell stabilizers have been shown to help contact lens users wear their lenses for longer periods of time.
146 Eye Drops Multiple-Action Allergy Eye drops Some eye drops contain more than one type of active ingredient. These are called dual-action or multiple-action eye drops.Antihistamine/decongestant combination eye drops reduce eye itching, watery eyes, and redness.
149 Eye Drops Side Effects and Risks of Allergy Eyedrops All medicine comes with some risk. Make sure you follow the recommended instructions when using eye drops. You should not use over-the-counter eye drops for more than two to three days. Long-term use of certain eye drops can actually make your eye symptoms worse.
150 Eye DropsYou should not use eye drops if you have an eye infection or glaucoma.Some eye drops may sting or burn when you place them in your eyes. Storing the eye drops in the refrigerator may help reduce such discomfort.
151 Eye Drops Self Care Advise Many eye drops cannot be used while wearing contact lensesRemove your lenses before using the drops and waiting at least 10 minutes before reinserting them.Do not rub your eyes, even though your eyes may be itchy. Rubbing them can make your symptoms worse.
152 Eye Drops Place a cool compress over your eyes. Wetting a flannel with cool water and holding it over your eyes will help ease your symptoms.Avoid exposure to the allergen, if possible.
154 Allergic Conjunctivitis Pharmacist referral situationsContact lens wearersChild or older personPain or altered visionGlaucoma or any other eye conditionPus or clear discharge from the eyePregnant or breastfeeding
156 AllergyOther CausesPets can be a major source of allergens in the homeExposure to pets (such as cats, dogs, guinea pigs, horses, rabbits, mice, rats) at home or work can trigger allergic reactions in some people.
157 AllergyCats and dogs are a major source of allergens in the home environment. The allergens come from the sweat glands in all cats and salivary glands in all dogs. Although the amount of allergen released can vary between breeds, there are no hypoallergenic animals or breeds.
158 AllergyAs allergens are stuck to the hair and skin of pets, the allergens become airborne when the pet sheds their hair. The allergens can remain airborne for some time. Cat allergen is especially difficult to remove from houses. It can remain in the house for months after the cat is removed. Cat allergen can be found in places where cats have never lived. For example, it can be carried around on clothing to schools and offices.
159 AllergyThe most effective method of allergen avoidance for people who are allergic to pets is removal of the pets from the home. For example, if there is no doubt that cat or other animal allergen is a major cause of symptoms then the best advice is for the animal to be removed from the home. It can be an emotional decision, but health should be a priority.
160 AllergyIf pets cause only minor problems, keeping pets out of bedrooms and living areas may be a compromise. Even then, it may take months after pet removal before allergen levels are reduced. The effectiveness of some measures such as washing animals frequently and using HEPA air filters remains uncertain.
161 AllergyDogs, guinea pigs, mice and rabbits are not as allergenic as cats and are more easily kept outside, but can still cause annoying and occasionally serious problems. Horse allergy is very serious and even animal hair on clothes may be sufficient to trigger asthma.
162 AllergyGreat care must be taken to shower and change clothes before returning to a home of a person allergic to horses. Birds may occasionally cause allergic symptoms. This is a different problem to pigeon fancier's lung which is a serious condition and requires complete avoidance.
163 AllergyMould in the home can show as mould, mildew or a musty smell. It is commonly found in bathrooms, refrigerators and in places with little air circulation such as walk-in and built-in wardrobes, and in bedrooms with ensuite bathrooms.If you are allergic to mould, you may consider:Removing visible mould by cleaning with bleach or other mould reduction cleaners
164 AllergyEnsuring adequate natural ventilation including the use of extractor fans sealing leaks in bathrooms and roofsClearing overflowing gutters and blocked under floor ventsRemoving indoor pot plants (which promote mould growth)Drying or removing wet carpetsNot working with garden compost or mulch
165 Pet AllergyAllergies to pets, particularly to cats and dogs, are a common cause of allergic disease, including asthma and allergic rhinitis (hay fever).
166 Pet AllergyThe main source of cat allergen is in the sebaceous glands in the cat's skinCats often lick themselves and as the main source of cat allergen is in the sebaceous glands, the licking helps spread the allergen. Cat allergen is sticky, and glues itself to hairs, dust particles (forming a persistent aerosol) and all parts of the home. As all cats have sebaceous glands, all cat breeds can potentially cause allergies.
167 Pet AllergyEven after removal of the pet, cat allergen can remain distributed throughout the home for up to 6 months and in the cat's bedding for up to 4 years. The allergen is so pervasive that it can even be measured in the homes of non-pet owners and on the clothing of co-workers who don't have pets. Cat allergen has even been detected in the Antarctic, even though cats have never been there.
168 Pet Allergy In dogs the main source of allergen is saliva As the main source of dog allergen is saliva, dander (shed skin particles) and hair can both help spread the allergen. Therefore all breeds of dog can potentially cause allergies, although some may not shed as much hair and dander (and therefore allergen) as others.
169 Pet Allergy Allergies to other animals Although not as common as cat and dog allergy, allergies to other animals including horses, mice, rats, rabbits, guinea pigs and birds are important. Transmission of these allergens on clothes and other items may be sufficient to trigger allergic rhinitis (hay fever) and asthma.
170 Pet Allergy Testing for allergies to animals It is important to note that up to 50% of people who are allergic to animals do not get immediate symptoms. If there is some doubt as to whether a pet is causing your allergy symptoms, your doctor can confirm your suspicion using skin prick tests or allergen specific IgE (RAST) allergy tests. You may be referred to a medical specialist (Allergist / Clinical Immunologist) for allergy testing.
171 Pet AllergyIn children a negative allergy test does not mean that a child won't become allergic to pets later.Some studies have suggested that increased exposure to cats and dogs may be associated with reduced sensitisation and allergic disease, whilst other studies have found that increased exposure is associated with increased sensitivity.
172 Pet AllergyWhat can be done to prevent a pet allergy? Changes that are simple to implement and have been proven to be effective are as follows:Do not bring a furred pet into the homeFind an existing pet a new homeDo not smoke, as exposure to environmental smoke makesA range of allergies (including pet allergies) more likely to develop.
173 Pet AllergyChanges that are difficult to implement or have not yet been proven are as follows:Restrict the pet to one areaKeep the pet out of the patient's bedroomUse high efficiency air cleaners, either central or portableRemove carpet or other reservoirs for allergens in the bedroomWash pets weekly.
174 Asthma and AllergyAllergy plays an important role in asthma, as one of the major factors associated with the cause and persistence of asthma. Around 8 in 10 people with asthma have positive allergy test results.Allergy and asthma are very common
175 Asthma and AllergyAllergy is very common in Australia and New Zealand, affecting around 4 in 10 people. Asthma is also common - affecting around 1 in 4 children, 1 in 7 teenagers and 1 in 10 adults. Globally, the prevalence of allergy is continuing to increase, particularly in developed countries, such as Australia and New Zealand.
176 Asthma and AllergyPeople with asthma experience a narrowing of the airways in the lungs, which obstructs the flow of air into and out of the lungs. This narrowing can be reversed using medications and people with asthma can therefore lead normal, active lives if they take regular preventer medication
177 Asthma and AllergyAsthma is most easily recognised by the following symptoms:Wheezing when breathing outA persistent irritable cough, especially at nightDifficulty in breathing and shortness of breathTightness and heaviness in the chestWheezing or coughing with exercise (exercise induced asthma).
178 Asthma and Allergy Triggers for asthma include Allergens Infections ExerciseCold air Changes in temperature and cigarette smoke.
179 Asthma and Allergy How does allergy play a role in asthma? There are two main ways in which allergy plays an important role in asthma:Allergy itself can produce the allergic inflammation in the airwaysExposure to one or more allergens can trigger an asthma attack.
180 Asthma and AllergyEffective management/Self care advice for asthma involvesControl of allergyIt is essential to determine if allergies are an important factor in your asthma. If you can reduce the amount of causative allergen/s to which you are exposed, your asthma will improve.Once you suspect that certain substances will cause an allergic reaction, you should obviously try and avoid, remove or minimise exposure to the offending allergen(s) whenever possible.
181 Asthma and Allergy Medication for asthma and allergy People with asthma should have a regularly reviewed ASTHMA ACTION PLAN, developed in consultation with their doctor, including asthma medications (preventers and relievers) and how these may need to be increased or decreased. If you have asthma and untreated allergic rhinitis (hay fever), it can be more difficult to control asthma symptoms.
182 Asthma and AllergyNASAL CORTICOSTEROIDS are the most effective long term medication for allergic rhinitis (hay fever). Like preventer medication for asthma they need to be used each day to be effective, in controlling asthma and lessening the need for asthma medication.
183 Asthma and AllergyNON-SEDATING ANTIHISTAMINES are used to treat allergic rhinitis (hay fever) symptoms and are safe for people with asthma.MEDICATIONS WHICH CAN CAUSE PROBLEMS for people with asthma include aspirin, non-steroidal anti-inflammatory medicines and beta blockers.
184 Asthma and AllergySome ‘natural' treatments such as Echinacea and royal jelly can cause life threatening allergic reactions (anaphylaxis) in some people with asthma. It is important to advise your pharmacist and doctor of any medications or ‘natural' treatments you are taking
185 Asthma and Allergy Allergy and Asthma Prevention If a parent has allergies and/or asthma their children have a higher risk of developing allergies and/or asthma. Although effective treatments are available it makes sense to try to prevent allergies and asthma from developing.
186 Asthma and AllergyBased on current evidence, the following suggestions can be provided:Breastfeeding: Where possible, breast feed your child for at least the first 6 months of life. If it isn't possible to breastfeed, a partially hydrolysed (hypo-allergenic) formula rather than conventional cow's milk formula is recommended in the first 6 months of life.
187 Asthma and AllergySmoking: Do not smoke during pregnancy, in the presence of the child or in enclosed spaces where the child will sleep or play.Even if you carry out these suggestions you may not be able to prevent children from developing allergies
188 Asthma and Allergy Common myths about allergies and asthma exposed Allergies and asthma are very common in Australia and New Zealand. Around 1 in 3 people will develop allergies some time during their life, and about 1 in 10 will develop asthma.
189 Asthma and AllergyFar from being a trivial inconvenience, allergies have a significant impact on quality of life and are associated with medical. Some allergies are even life threatening. Unfortunately, many people confuse myth with reality in the way they view and treat allergies and asthma.
190 Asthma and Allergy Common myths about allergies and asthma exposed Myth 1 Allergies are uncommonReality: The frequency of allergic disease has approximately doubled in the past few decades. In Australia and New Zealand, around:1 in 3 people will develop allergies at some time during life;1 in 5 will develop atopic dermatitis;
191 Asthma and Allergy 1 in 6 will have an attack of hives (urticaria); 1 in 10 people have asthma;1 in 20 will develop a food allergy (usually transient); and1 in 100 will have a life-threatening allergy known as anaphylaxis.
192 Asthma and Allergy Myth 2 Allergies are harmless Reality: Allergies are a serious problem in Australia and should not be ignored. Untreated allergies have a significant impact on quality of life. Allergic rhinitis (hayfever) for example, results in poor quality sleep, fatigue and daytime sleepiness. Adults find it harder to think and function at work, suffer from greater absenteeism and more work-related injury. They are more irritable and moody than healthier people and find it harder to make important decisions.
193 Asthma and AllergySchool-aged children with allergic rhinitis can do poorly in examinations and often cannot recall information taught during class. Untreated allergies can also worsen other chronic respiratory problems such as asthma, sinusitis and skin disorders such as eczema and urticaria (hives). Some allergies to foods, drugs and insect stings can lead to a potentially life threatening reaction called anaphylaxis - a systemic allergic reaction which can be fatal, and leads to the death of 10 to 20 Australians each year.
194 Asthma and Allergy Myth 3 Smoking does not trigger asthma Reality: Babies who are born to smoking mothers have a greater chance of developing asthma than children of non-smoking mothers. Smoking is also a known trigger of asthma attacks and should not be ignored. So if you must smoke, do it outside and away from your children.
195 Asthma and Allergy Myth 4 Flowering plants cause hay fever Reality: Seasonal allergic rhinitis, commonly known as hayfever, is caused by allergy to pollen, rather than hay. Pollen allergy tends to be due to air borne pollen from wind pollinated grass, weed and tree species.
196 Asthma and AllergyBy contrast, the pollen of flowering plants is large and sticky, does not blow very far, and requires birds and bees for pollination. Therefore, when people complain that scented flowers trouble them, it is usually due to chemical irritation from the perfume that makes them sneeze rather than the pollen.
197 Asthma and Allergy Myth 5 Moving interstate can cure allergies Reality: Allergic rhinitis (hayfever) may be triggered by wind-blown pollen in spring and summer, or by other allergens such as house dust mite, animal danders and mould spores all year round. Moving away from the source of allergen (such as interstate, or from inland areas to the coast) may temporarily relieve allergies
198 Asthma and AllergyUnfortunately allergic people are also prone to developing new allergies, and often symptoms reappear within a few years with exposure to new plants, or other sources of allergen such as moulds or house dust mite
199 Asthma and AllergyMyth 6 Continuous exposure to animals will desensitize you to themReality: If you are allergic to an animal, continuous exposure will not decrease your allergy. In fact, 1 in 3 people who are already allergic and exposed to indoor pets will become allergic to them as well over time. Keeping indoor pets is also associated with asthma and the need for more medication.
200 Asthma and AllergyIf you are allergic to animals, sensitivity often worsens with ongoing exposure. The best way to relieve symptoms is to avoid the animal, minimize exposure to household pets by removing them from the home or at least keeping them out of the bedroom, have hard flooring and wash the animal regularly to reduce the amount of allergen they shed.
201 Asthma and AllergyMyth 7 You cannot develop an animal allergy if you do not yourself have petsReality: Animal allergens, particularly cat and horse allergen can be carried on clothes. This may sensitize other people who do not have pets themselves and provoke symptoms in sensitized individuals.
202 Asthma and AllergyAllergen can continuously suspended in the air, even if the animal has been removed from the house or is not in the bedroom. While the amount of allergen shed by an individual animal may vary with a number of factors (sex, whether de-sexed or not, short or long hair, hair or 'wool'), the actual allergen is the same amongst species. Allergies to other animals such as guinea pigs, horses and mice have also been described. Even iguanas can trigger allergies. There are no hypoallergenic animals!
203 Asthma and AllergyMyth 8 Some animals are better for people with asthma and allergiesReality: The allergens in cats are mainly from their sebaceous glands in their skin and the main source of allergens in dogs is from their saliva. Even if some breeds do not shed hair, the allergen can still become attached to dust particles in the house (such as walls, carpets, bedding, clothing and drapes) and does not easily break down with time.
204 Asthma and AllergyMyth 9 Eliminating wheat and milk helps asthma and hay feverReality: Diet plays a minor role in the management of asthma or allergic rhinitis (hayfever). While some children with food allergies go on to develop eczema, asthma or allergic rhinitis as well, taking all people off wheat or dairy products as a routine is almost always a waste of time. Such diets can adversely affect nutrition (particularly in children) and directs effort into unproductive areas.
205 Asthma and AllergyWhen food allergy does occur, reactions are usually of rapid onset, severe and obvious. They are almost always accompanied by rashes, throat swelling, vomiting or sometimes a more subtle worsening of atopic eczema. Nuts, fish, shellfish, milk and eggs are the most common food allergies in children.Scientific studies show no evidence that milk either increases mucus production or worsens asthma! Eliminating wheat and milk will help your allergy, but only if you are confirmed to be allergic to wheat and milk
206 Asthma and AllergyMyth 10 Colours and preservatives are a common cause of asthmaReality: Preservatives like sodium metabisulfite (220, 221, 222) in wine, dried fruits, vinegar, grapes and some fruit salads can worsen, but do not cause asthma. Inhalation of small amounts of sulphur dioxide released may cause a reflex contraction of the bronchial tubes.
207 Asthma and AllergyMonosodium Glutamate (MSG) also has a bad reputation for triggering asthma in some people, but scientific studies have shown this to be a relatively rare problem. Benzoates (used in cordials) can sometimes cause problems. Unfortunately, allergy testing is unreliable for confirming sensitivity to these substances.
208 Asthma and AllergyMyth 11 Alternative tests and treatments are just as effective as conventional tests and medications for allergy and asthmaReality: There are several unorthodox 'tests' for allergy such as cytotoxic food testing, Vega testing, kinesiology, iridology, pulse testing, Alcat testing and Rinkel's Intradermal skin testing. These have no scientific basis, are unreliable and have no useful role in the assessment of allergy.
209 Asthma and AllergyOn the other hand, Skin tests and blood allergen specific IgE (RAST) tests are reliable and scientifically validated allergy tests. Together with a medical history and examination hese tests can help your doctor define the cause of your allergies and are rebated by Medicare in Australia.
210 Asthma and Allergy Myth 12 Allergies and asthma can be cured Reality: Even though effective treatments are available, there are currently no cures for asthma or allergies. The closest thing to a cure for allergy is immunotherapy (desensitisation), which is effective for treating some allergies like allergic rhinitis (hayfever), asthma and stinging insect allergy, but not currently for treating food allergies.
211 Asthma and Allergy Myth 13 Asthma and hay fever sprays are dangerous Reality: Inhaled medications, including corticosteroids (preventative treatment) are commonly used to treat asthma. They are very safe and effective, as long as they are used at an appropriate dose under medical supervision.
212 Asthma and AllergySimilar medications (intranasal corticosteroid sprays) are often used to treat moderate to severe allergic rhinitis (hayfever). There is no evidence that long term use of these medications (in appropriate dosage and under medical supervision) is harmful, although medical advice should be sought if side effects occur.
213 Asthma and AllergyMyth 14 Many children grow out of their asthma and allergiesReality: Allergies can unfortunately last for many years. For example, it is known that:85 per cent of children with atopic dermatitis (eczema) improve by their teenage years, but often have dry and irritable skin and problems with soap and some cosmetics for life
214 Asthma and AllergyMyth 15 Allergy drugs are dangerous and make you sleepyReality: Non-drowsy antihistamines are readily available from pharmacies. These medicines are just as effective than sedating antihistamines (and probably more so), rarely make people drowsy, have been proven to be safe when driving and hardly ever make children irritable or hyperactive. Because they last a lot longer in the body, they are also more convenient to take (typically once daily).
215 Asthma and AllergyMyth 16 There is no way of getting rid of house dust mitesReality: The greatest concentration of house dust mites and their allergenic faecal particles is in carpeted bedrooms and bedding and in houses where there are domestic animals, especially cats.
216 Asthma and AllergyPolished boards or other impervious floor coverings, regular washing of bed linen and encasing mattresses and pillows in barrier encasing will substantially reduce exposure to dust mite allergen. Although it will not eradicate the dust mite, vacuuming once per week will reduce the number of dust mites, particularly if HEPA filters are used
217 Asthma and Allergy Myth 17 A little bit of peanut does no harm Reality: Contact with a trace amount of peanut can be fatal for a peanut allergic individual, if they are extremely sensitive to peanuts.Myth 18 Damp houses are just as healthy as dry housesReality: Damp houses have a higher mould content than dry homes and indoor mould is a common cause of perennial allergic rhinitis, sinusitis, bronchitis as well as asthma.
218 Food Allergy & Food Intolerance Food allergy and food intolerance are commonly confused as symptoms of food intolerance occasionally resemble those of food allergy. However, food intolerance does not involve the immune system and does not cause severe allergic reactions (known as anaphylaxis). Food intolerance also does not show on allergy testing.
219 Food Allergy & Food Intolerance Food allergy is increasing Allergies in general are on the increase worldwide and food allergies have also become more common, particularly peanut allergy in preschool children. About 60 per cent of allergies appear during the first year of life. Cow’s milk allergy is one of the most common in early childhood. Most children grow out of it before they start school.
220 Food Allergy & Food Intolerance Allergy can be inherited Children who have one family member with allergic diseases (including asthma or eczema) have a 20 to 40 per cent higher risk of developing allergy. If there are two or more family members with allergic diseases, the risk increases to 50 to 80 per cent.
221 Food Allergy & Food Intolerance Food intolerance is a chemical reaction Food intolerance is a ‘chemical’ reaction that some people have after eating or drinking some foods; it is not an immune response. Food intolerance has been associated with asthma, chronic fatigue syndrome and irritable bowel syndrome (IBS).
222 Food Allergy & Food Intolerance Symptoms of food allergy and intolerance It can be difficult to tell the difference between the symptoms of food allergy and food intolerance. Usually, symptoms caused by food allergy develop very soon after consuming the food but, while symptoms caused by food intolerance can be immediate, they may also take 12 to 24 hours to develop.
223 Food Allergy & Food Intolerance Food intolerance reactions are usually related to the amount of the food consumed. They may not occur until a certain amount (threshold level) of the food is eaten, but this amount varies for each person.The symptoms of food allergy and intolerance can also be caused by other conditions, so it’s important to see your doctor for a medical diagnosis
224 Food Allergy & Food Intolerance Symptoms of food intolerance can include: nervousness, tremorSweatingPalpitationsRapid breathingHeadache, migraineDiarrhoea
225 Food Allergy & Food Intolerance Burning sensations on the skinTightness across the face and chestBreathing problems – asthma-like symptomsAllergy-like reactions
226 Food Allergy & Food Intolerance The symptoms of food allergy can be life threatening. Common symptoms include: itching, burning and swelling around the mouthRunny noseSkin rash (eczema)Hives (urticaria – skin becomes red and raised)
227 Food Allergy & Food Intolerance Diarrhoea, abdominal crampsBreathing difficulties, including wheezing and asthmaVomiting, nausea
228 Food Allergy & Food Intolerance Body parts affected by food allergy Various sites on the body can be affected by an allergic reaction to food, including: eyes – itching, wateringNose – stuffiness, sneezingMouth – itching, swellingThroat – swellingDigestive system – stomach pains, vomiting, diarrhoea
229 Food Allergy & Food Intolerance Skin – rashes, such as hives (urticaria) or atopic dermatitisLungs – wheeze, cough, asthma, more common in children than adultsCentral nervous system – headache, irritability, fatigue, convulsions.
230 Food Allergy & Food Intolerance Causes of food allergy Peanuts, tree nuts, eggs, milk, wheat, sesame, fish, shellfish and soy cause about 90 per cent of food allergic reactions. Peanut allergy is one of the most common allergies in older children as only approximately one in four children will outgrow peanut allergy.
231 Food Allergy & Food Intolerance Causes of food intolerance The foods that tend to cause intolerance reactions in sensitive people include: dairy products, including milk, cheese and yoghurtChocolateEggs, particularly egg whiteFlavour enhancers such as MSG (monosodium glutamate)
232 Food Allergy & Food Intolerance Food additivesStrawberries, citrus fruits and tomatoesWine, particularly red wineHistamine and other amines in some foods
233 Food Allergy & Food Intolerance Finding the allergen When symptoms appear within a few minutes of eating the particular food, it makes pinpointing the allergen an easy task. However, if the cause is unknown, diagnostic tests may be needed, such as: keeping a food and symptoms diary to check for patterns
234 Food Allergy & Food Intolerance Removing all suspect foods for two weeks, then reintroducing them one at a time to test for reactions (except in cases of anaphylaxis). This must only be done under medical supervisionSkin prick tests using food extractsAllergy blood tests
235 Food Allergy & Food Intolerance Avoiding the food The easiest way to treat a food allergy or intolerance is to eliminate the offending food/s from the diet. Sometimes, the body can tolerate the food if it is avoided for a time, then reintroduced in small doses, particularly for food intolerances. Before you eliminate or reintroduce foods, seek advice from a specialist doctor and dietitian.
236 Food Allergy & Food Intolerance Preventing food allergy in children Allergy prevention in children is an active area of research. Findings to date indicate that: Prenatal – there is no conclusive evidence that avoiding allergens in pregnancy will help prevent allergies in your child.
237 Food Allergy & Food Intolerance Postnatal – exclusive breastfeeding during the first four to six months appears to protect against the development of allergies in early childhood. Exposure to cigarette smoke and starting solids early can increase the risk of developing allergies in early childhood.
238 Food Allergy & Food Intolerance Breastfeeding – avoidance of a food by a woman while breastfeeding should only be undertaken under the advice of a clinical immunology or allergy specialist, and with the help of a dietitian.Soy formula – studies have shown that using soymilk formula does not prevent the development of allergies in children.
239 Food Allergy & Food Intolerance Partially hydrolysed formula – partially hydrolysed cow’s milk-based formula (commonly referred to as ‘HA' formula) has been processed to break down some of the proteins. These formulas have been recommended to help prevent allergies. However, recent studies suggest that partially hydrolysed formula may not always have a significant protective effect against allergic disease, as results from different studies are variable.
240 Food Allergy & Food Intolerance Self care advice for food allergiesTo avoid allergic foods, learn the terms used to describe these foods on food labels, for example: milk protein – milk, non-fat milk solids, cheese, yoghurt, caseinates, whey, lactoseLactose – milk, lactoseEgg – eggs, egg albumen, egg yolk, egg lecithin
242 Food Allergy & Food Intolerance Pharmacist referral situations:Persons who experience an itchy mouth from raw fruits and vegetablesPersons who have experienced allergic symptoms (urticaria,angioedema, itch, wheezing, gastrointestinal responses) in association with food exposure.
243 Food Allergy & Food Intolerance Infants with gastrointestinal symptoms including vomiting, diarrhoea (particularly with blood).Persons with a diagnosed food allergy.
244 AnaphylaxisAny substance you are severely allergic to can trigger anaphylaxis. The most common food culprits include nuts, shellfish, and eggs. Bee stings and other insect bites can cause anaphylaxis as well. Drug allergies are also common triggers; according to the World Allergy Organization, drugs may be responsible for as much as 20 percent of deaths from anaphylaxis worldwide.Some less common triggers of anaphylaxis include exercise and latex
245 Anaphylaxis Signs and Symptoms of Anaphylaxis Anaphylaxis can cause a multitude of symptoms almost immediately after exposure to the trigger. The following are possible signs and symptoms of anaphylaxis:Chest tightnessTrouble breathing or speakingFeeling of a lump in the throatTongue swelling
246 Anaphylaxis Wheezing or a high-pitched sound when breathing Coughing Feeling flushed or hotDifficulty swallowing (dysphagia)Facial swellingHives or rash
247 AnaphylaxisChanges in the color of the skin, such as pink and flushed, pale, or blueGastrointestinal symptoms, such as diarrhea, nausea, or vomitingUnconsciousnessDeathAlong with the symptoms listed above, a person may also experience severe anxiety or a feeling of impending doom.
249 Anaphylaxis Moderate to mild allergic reaction In some cases, anaphylaxis is preceded by signs of a mild to moderate allergic reaction: Swelling of face, lips and eyes. Hives or welts on the skin. Tingling mouth,stomach pain, vomiting (these are signs of a mild to moderate allergic reaction to most allergens, however, in insect allergy these are signs of anaphylaxis).
251 AnaphylaxisActionFor insect allergy, flick out the sting if it can be seen (but do not remove ticks) Stay with person and call for help Give medications if prescribed (whilst antihistamines may be used to treat mild to moderate allergic reactions, if these progress to anaphylaxis then adrenaline is the only suitable medication) Locate adrenaline auto injector if available
252 Anaphylaxis Anaphylaxis ( Severe allergic reaction) Continue to watch for any one of the following signs of anaphylaxis (severe allergic reaction):Difficult/noisy breathingSwelling of tongueSwelling/tightness in throat Difficulty talking and/or hoarse voice
253 Anaphylaxis Wheeze or persistent cough Persistent dizziness or collapsePale and floppy (in young children)
254 AnaphylaxisActionLay person flat - if breathing is difficult, allow to sit - do not allow them to stand or walkGive the adrenaline auto injector if availableCall AmbulanceFurther adrenaline doses may be given (when an additional adrenaline auto injector is available), if there is no response after 5 minutes
256 AnaphylaxisAn epinephrine auto injector is a medical device used to deliver a measured dose (or doses) of epinephrine (also known as adrenaline) using auto injector technology, most frequently for the treatment of anaphylaxis
257 AnaphylaxisThe devices contain a spring-loaded needle that exits the tip of the device (in some cases through a sterile membrane) and penetrates the recipient's skin, to deliver the medication via subcutaneous or intramuscular injection.Epinephrine auto injectors contain a pre-determined dose of epinephrine, usually between 300 μg and 500 μg of active ingredient at a concentration of 1:1000.
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