Medications such as antihistamines or antidepressants that interfere with the allergy test must be stopped from 2 days to 6 weeks or more before the test. Resuscitation facilities must be available during allergy testing because anaphylaxis occasionally occurs after intradermal doses of reagents, especially penicillin. The test procedure consists of a positive control (usually histamine), a negative control - a solution without the allergen, and then a test - each suspected allergen. If the test substance causes an allergic reaction, raised, red, itchy wheals may appear within about 20 minutes; generally, the greater the reaction, the more sensitive the patient. A negative skin test means that the patient is not allergic to that particular allergen. A complication of skin testing is that it can cause sensitivity to the test compound.
To avoid allergic reactions in the future, known allergens should be avoided, which is easier said than done, as sensitive individuals may react to minute traces, and allergens may be in the most unexpected places (commercial Prepared foods and beverages are more likely than natural products) ).
Individuals with a history of complicated allergies should be referred to a specialist allergy clinic for careful evaluation and management. Treatment consists of drugs that block allergic mediators or cellular activation and degranulation (Table 17.6). These include antihistamines, corticosteroids, and cromolyn. Antileukotrienes (leukotriene receptor antagonists such as montelukast or zafirlukast) are also effective. Intravenous monoclonal anti-IgE antibody (omalizumab), which binds free and B cell-associated IgE, causing their destruction. Immunotherapy by desensitization, or desensitization, is a treatment in which patients are gradually inoculated with gradually increasing doses of the allergen allergen for at least a year - but this is potentially dangerous because it induces allergies reaction. diazolidinyl urea
It is also often recommended that patients with severe allergic reactions always have epinephrine (epinephrine) on hand for self-administration subcutaneously in the event of a reaction (eg, EpiPen; see below).
There is no reliable evidence to support the use of alternative medicines for allergy management.