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Allergy and Asthma Care North Texas Survival Guide Presented By David Zahaluk, MD Main Street Medical Care
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>5...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>T...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>C...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Courtesy of About....
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Airborne: sneezing...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Courtesy of About....
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Complications </li></ul><ul><li>Sinusitis </l...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Common Local Allergens by RAST </li></ul><ul><li>Indoor (...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Non Allergic Rhinitis </li></ul><ul><li>Chronic sneezing,...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Avoidanc...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Avoidanc...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Hyposens...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Topical Medications </li></ul><ul><li...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Topical Medications </li></ul><ul><li...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Systemic Medications </li></ul><ul><l...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Episodic lung cond...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Three factors driv...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Courtesy of  www.h...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Symptoms </li></ul><ul><li>Three Cardinal Sympto...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Complications </li></ul><ul><li>Decreased qualit...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Triggers </li></ul><ul><li>Viral and bacterial i...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Symptomatic Classification </li></ul>Symptoms be...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Step Therapy </li></ul><ul><li>Courtesy NIH </li...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Maintenance Meds </li></ul><ul><li>Two...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Prevention </li></ul><ul><li>Vaccines ...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Acute Exacerbation </li></ul><ul><li>N...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Courtesy NIH </li></ul>
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>What To Do Next </li></ul><ul><li>Go through your home to...
Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Our Practice </li></ul><ul><li>Family Practice and Urgent...
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Allergy & Asthma Prevention- Main Street Medical Care

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Learn all about your North Texas allergies! How can you treat and prevent?

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Transcript of "Allergy & Asthma Prevention- Main Street Medical Care"

  1. 1. Allergy and Asthma Care North Texas Survival Guide Presented By David Zahaluk, MD Main Street Medical Care
  2. 2. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>50 million patients in the US at a cost of $4.5 billion </li></ul><ul><li>How the body defends itself against foreign invaders </li></ul><ul><li>Here’s what happens… </li></ul><ul><li>Ragweed pollen gets stuck on your nasal linings (mucosa) </li></ul><ul><li>Plasma cells in the mucosa lining turn on & make antibodies (sensitization) </li></ul><ul><li>Antibodies find and attach to mast cells that contain histamine (priming) </li></ul>
  3. 3. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>The next ragweed gets grabbed by the antibody which turns on the mast cell and releases histamine, leukotrienes, etc. </li></ul><ul><li>Histamine immediately dilates vessels causing tissues to sell, itch and leak serum and mucus </li></ul><ul><li>The “late phase” reaction happens 4-24 hours after exposure when other cells are attracted to the site causing tissue damage and swelling </li></ul>
  4. 4. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – The Nature of the Problem </li></ul><ul><li>Courtesy of Web MD </li></ul>
  5. 5. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Courtesy of About.com </li></ul>
  6. 6. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Airborne: sneezing, runny nose, congestion, watery eyes </li></ul><ul><ul><li>Pollens, molds, dust mites, animal dander </li></ul></ul><ul><li>Food: abdominal pain, bloating, cramping, diarrhea, hives </li></ul><ul><ul><li>Peanuts, wheat, shellfish, eggs, milk, soy </li></ul></ul><ul><li>Insect Stings: hives, anaphylaxis </li></ul><ul><li>Medications: hives, anaphylaxis </li></ul><ul><li>Latex/Poison Ivy: dermatitis </li></ul>
  7. 7. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Symptoms </li></ul><ul><li>Courtesy of About.com </li></ul>
  8. 8. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergies – Complications </li></ul><ul><li>Sinusitis </li></ul><ul><ul><li>70% of recurrent sinusitis is caused by allergies </li></ul></ul><ul><li>Ear Infections </li></ul><ul><li>Asthma </li></ul><ul><ul><li>Peak month is September based on ER and hospital visits </li></ul></ul><ul><li>Anaphylaxis </li></ul><ul><ul><li>Potentially fatal </li></ul></ul>
  9. 9. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Common Local Allergens by RAST </li></ul><ul><li>Indoor (Perennial) </li></ul><ul><li>Pests </li></ul><ul><li>American cockroach </li></ul><ul><li>Pet allergens </li></ul><ul><li>Cat hair, dog epithelium </li></ul><ul><li>Funguses </li></ul><ul><li>Aspergillus fumigatus, Penicillium notatum </li></ul><ul><li>Outdoor (Seasonal) </li></ul><ul><li>Weeds </li></ul><ul><li>Ragweed, Nettle, Pigweed, Sheep sorrel, English plantain, Wingscale </li></ul><ul><li>Grasses </li></ul><ul><li>Johnson grass, Kentucky bluegrass, Bahia grass, Bermuda grass, short grass </li></ul><ul><li>Trees </li></ul><ul><li>American Elm, Box Elder, Mesquite, Mountain Cedar, Sweet Gum, White Ash, White Hickory, White Mulberry, White Oak </li></ul>
  10. 10. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Non Allergic Rhinitis </li></ul><ul><li>Chronic sneezing, congestion, itching or runny nose with no evidence of allergies (no nasal eosinophils and negative allergy testing) </li></ul><ul><li>Vasomotor - Causes: cold, perfumes, smoke, bright sunlight </li></ul><ul><ul><li>treat with Atrovent N/S (anticholinergic) </li></ul></ul><ul><li>Hormonal - Causes: pregnancy, low thyroid </li></ul><ul><ul><li>treat with hypertonic saline N/S </li></ul></ul><ul><li>Infectious </li></ul><ul><ul><li>treat with decongestants </li></ul></ul><ul><li>Rhinitis Medicamentosa – Overuse of OTC decongestant spray </li></ul><ul><ul><li>Stop using Afrin, Dristan, Otrivin; may substitute nasal steroid spray </li></ul></ul>
  11. 11. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Avoidance Strategies </li></ul><ul><li>Pollen </li></ul><ul><ul><li>Stay indoors; close doors and windows at home and in car </li></ul></ul><ul><ul><li>Don’t dry clothes outdoors </li></ul></ul><ul><ul><li>Shower and wash clothes after being outdoors </li></ul></ul><ul><li>Grass </li></ul><ul><ul><li>Avoid cutting grass or wear mask </li></ul></ul><ul><li>Dust Mites </li></ul><ul><ul><li>Keep mite-proof covers on mattresses, box springs and pillows </li></ul></ul><ul><ul><li>Vacuum mattresses </li></ul></ul><ul><ul><li>Wash bedding weekly in hot water </li></ul></ul><ul><ul><li>Remove clutter and stuffed animals (or put in freezer) </li></ul></ul><ul><ul><li>Replace carpet with vinyl or hardwood </li></ul></ul><ul><ul><li>Install HEPA filters in vacuum and central air </li></ul></ul>
  12. 12. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Avoidance Strategies </li></ul><ul><li>Mold Spores </li></ul><ul><ul><li>Maintain low humidity </li></ul></ul><ul><ul><li>Fix leaky pipes, sinks and tubs </li></ul></ul><ul><ul><li>Clean damp areas with dilute bleach solutions </li></ul></ul><ul><ul><li>Use exhaust fan in bathroom during showers </li></ul></ul><ul><ul><li>Clean refrigerator tray regularly </li></ul></ul><ul><li>Pet Dander </li></ul><ul><ul><li>Keep pets off beds and linens or out of bedroom entirely </li></ul></ul><ul><ul><li>Install HEPA filters in vacuum and central air </li></ul></ul>
  13. 13. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Prevention </li></ul><ul><li>Hyposensitization </li></ul><ul><li>Similar to vaccine: inject small doses of allergen under skin to get your body “used to” the substance and decrease allergy response </li></ul><ul><li>Start with scratch test, prick test or RAST to determine what you are allergic to </li></ul><ul><li>Begin with 4-6 months of shots once or twice weekly to build up to a maintenance dose; then 4-6 months more of shots every 2 to 4 weeks in maintenance phase </li></ul><ul><li>Optimal duration of therapy unknown; duration of benefit hard to predict </li></ul><ul><li>Works well in: </li></ul><ul><ul><li>Allergies and asthma, poor response to medication therapy </li></ul></ul><ul><li>Poor response to: </li></ul><ul><ul><li>Food allergy, atopic dermatitis, latex allergy, medication allergy </li></ul></ul><ul><li>Caution with severe or unstable asthma, beta blocker therapy or autoimmune disease (MS, thyroid disease) </li></ul>
  14. 14. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Topical Medications </li></ul><ul><li>Nasal Sprays </li></ul><ul><li>Antihistamines: Astelin </li></ul><ul><li>Steroids: Flonase, Veramyst, Nasonex, Nasacort </li></ul><ul><li>Mast cell stabilizer: Nasalcrom (OTC) </li></ul><ul><li>Hypertonic Saline: NeilMed, EntSol </li></ul><ul><li>Decongestants: Afrin, Dristan, Otrivin </li></ul>
  15. 15. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Topical Medications </li></ul><ul><li>Eye Drops </li></ul><ul><li>Antihistamines: Patanol, Optivar, Zaditor </li></ul><ul><li>Mast cell stabilizer: Cromolyn, Alocril </li></ul><ul><li>NSAID: Acular </li></ul><ul><li>Decongestants: Vasocon, Naphcon, Visine (OTC) </li></ul>
  16. 16. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Allergy Treatment – Systemic Medications </li></ul><ul><li>Antihistamines – Claritin, Zyrtec, Allegra, Lodrane </li></ul><ul><li>Decongestants – Sudafed </li></ul><ul><li>Drying agents – Methscopalamine (Allerx, Rescon) </li></ul><ul><li>Leukotriene Inhibitor – Singulair </li></ul><ul><li>Steroids – oral, IM, IV </li></ul><ul><li>- watch bone loss, appetite, blood sugar </li></ul><ul><li>Epinephrine – for anaphylaxis </li></ul>
  17. 17. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Episodic lung condition that causes airway swelling and obstruction </li></ul><ul><li>Affects 22 million in the US, including 6 million kids </li></ul><ul><li>Every day in the US: </li></ul><ul><ul><li>30,000 asthma attacks </li></ul></ul><ul><ul><li>5,000 ER visits </li></ul></ul><ul><ul><li>1,000 hospital admission </li></ul></ul><ul><ul><li>11 deaths </li></ul></ul>
  18. 18. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Three factors drive asthma: </li></ul><ul><li>Bronchoconstriction </li></ul><ul><li>– airway narrowing due to muscle spasm </li></ul><ul><li>Tissue edema </li></ul><ul><li>– inflammatory response causes lining to swell </li></ul><ul><li>Mucus hypersecretion </li></ul><ul><li>– goblet cells overproduce mucus </li></ul><ul><li>Courtesy of Quickcare.com </li></ul>
  19. 19. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – What Is It? </li></ul><ul><li>Courtesy of www.hse.gov.uk/asthma </li></ul>
  20. 20. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Symptoms </li></ul><ul><li>Three Cardinal Symptoms </li></ul><ul><li>Cough </li></ul><ul><li>Wheeze/shortness of breath </li></ul><ul><li>Chest pain/tightness/pressure </li></ul><ul><li>Severe Symptoms: </li></ul><ul><li>Inability to speak Wheeze breathing in and out </li></ul><ul><li>Blue lips & fingernails Nonstop coughing </li></ul><ul><li>Rapid breathing Fatigue/confusion/sweating </li></ul><ul><li>Inability to fully exhale Audible wheeze </li></ul>
  21. 21. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Complications </li></ul><ul><li>Decreased quality of life (fatigue, underperformance, anxiety/depression) </li></ul><ul><li>Pneumonia </li></ul><ul><li>Collapsed Lung </li></ul><ul><li>Respiratory failure/Death </li></ul>
  22. 22. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Triggers </li></ul><ul><li>Viral and bacterial infections </li></ul><ul><li>Allergens </li></ul><ul><ul><li>Dust mites, Cockroach allergens, Pets (hamsters, rabbits), Mold </li></ul></ul><ul><li>Second hand smoke </li></ul><ul><li>Cold, dry air </li></ul><ul><li>Exercise </li></ul><ul><li>GERD </li></ul><ul><li>Anxiety </li></ul><ul><li>Medications </li></ul><ul><ul><li>ASA, NSAIDs, Beta blockers </li></ul></ul>
  23. 23. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Symptomatic Classification </li></ul>Symptoms between flares Night symptoms Symptoms and use of rescue Severity Extreme Nightly Multiple / Day Severe Persistent Moderate 5+ / month Daily Moderate Persistent Minor 3-4 / month 3-6 / week Mild Persistent No 0-1 / month 0-1 / week Intermittent
  24. 24. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma – Step Therapy </li></ul><ul><li>Courtesy NIH </li></ul>
  25. 25. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Maintenance Meds </li></ul><ul><li>Two Mainstays of Therapy: </li></ul><ul><li>SABA – Proventil, Ventolin or Albuterol </li></ul><ul><li>ICS – Pulmicort, Aerobid, Flovent, Azmacort </li></ul><ul><ul><li>Low, medium or high dose based on # puffs/day </li></ul></ul><ul><li>ICS + LABA - Advair </li></ul><ul><li>ICS + SABA – Symbicort </li></ul><ul><li>Also consider </li></ul><ul><li>Singulair </li></ul><ul><li>Zyflo </li></ul><ul><li>Xolair </li></ul>
  26. 26. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Prevention </li></ul><ul><li>Vaccines </li></ul><ul><ul><li>Flu, PVX </li></ul></ul><ul><li>Peak Flow Meter </li></ul><ul><li>Control allergies, GERD </li></ul><ul><li>Regular checkups </li></ul><ul><li>Have written plan for flares </li></ul><ul><li>Smoking cessation </li></ul>
  27. 27. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Asthma Treatment – Acute Exacerbation </li></ul><ul><li>Nebulizer treatments – multiple (frequent reassessments) </li></ul><ul><li>Supplemental O2 </li></ul><ul><li>Treat triggers </li></ul><ul><li>Steroids – inhaled, oral, IM, IV </li></ul><ul><li>Admit if doesn’t respond well in the first 4-6 hours </li></ul><ul><li>Theophylline </li></ul><ul><li>Adrenaline </li></ul><ul><li>Intubation/mechanical ventilation </li></ul>
  28. 28. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Courtesy NIH </li></ul>
  29. 29. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>What To Do Next </li></ul><ul><li>Go through your home to practice allergen avoidance </li></ul><ul><li>Ask your doctor to evaluate you and put together an allergy/asthma treatment plan </li></ul><ul><li>Discuss Epipen with your doctor for anaphylaxis </li></ul><ul><li>Put asthma plan up where everyone at home can see </li></ul><ul><li>Use Peak Flow Meter daily </li></ul>
  30. 30. Main Street Medical Care Allergy & Asthma Survival Guide <ul><li>Our Practice </li></ul><ul><li>Family Practice and Urgent Care </li></ul><ul><li>Wait time guarantee: “You will be seen within 1 hour or your visit is free” </li></ul><ul><li>Free visit card for all attendees today courtesy of Trane </li></ul><ul><li>Sign up for our ‘ Today’s Health Matters ’ newsletter </li></ul><ul><li>Located across from the Medical Center of Lewisville 972-221-3500 </li></ul>

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