November 30, 2017:
New Clinical Guidelines from the US on allergic rhinitis (hay fever) treatment were published this week (28 November 2017) in the Annals of Internal Medicine http://annals.org/aim
The Guidelines were developed by representatives of the American Academy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy, Asthma and Immunology (ACAAI). Their recommendations for initial treatment of seasonal allergic rhinitis emphasise the use of an intranasal corticosteroid rather than an intranasal corticosteroid in combination with an oral antihistamine.
The Australasian Society of Clinical Immunology and Allergy (ASCIA) website includes the following information for patients, consumers and carers about allergic rhinitis medication options:
- Intranasal corticosteroid nasal sprays (INCS) have a potent action on inflammation when used regularly (like asthma preventer medications). These need to be used regularly and with careful attention to the way in which they are used. Different brands of INCS vary in strength and effectiveness, so it is important to read the labels and check details with your doctor or pharmacist.
- Combination medications containing an antihistamine and intranasal corticosteroid nasal spray are available and offer the combined advantages of both medications.
- Antihistamine tablets, syrups, intranasal sprays and eye drops (non-sedating) help to reduce symptoms (sneezing, itchy and irritating eyes), but they are not as effective in controlling severe nasal blockage and dribble. The advantage of antihistamines is their flexibility; you can take them when you have problems, and avoid them when you are well. Antihistamine eye drops can be helpful in controlling watery eyes due to allergies.
In addition, the ASCIA allergic rhinitis clinical update for health professionals includes the following key points:
- Intranasal corticosteroids sprays or combined intranasal/antihistamine sprays are recommended preventer treatments.
- Patients should be instructed on the correct and consistent use of intranasal sprays - see ASCIA Treatment Plan for Allergic Rhinitis:
- Effective treatment of allergic rhinitis is important in management of asthma.
- If patients are allergic to pollen, recommend staying indoors during thunderstorms in pollen seasons and use preventer treatments.
- Referral to a specialist should be considered when severe or inadequately controlled allergic rhinitis persists and consideration is being made for allergen immunotherapy.
- Allergen immunotherapy is effective in reducing the frequency and severity of symptoms of allergic rhinitis.
For further information from the ASCIA website go to:
https://etrainingpharm.ascia.org.au/ - e-training for pharmacists accredited by the APC
https://allergicrhinitis.ascia.org.au/ - e-training for other health professionals
November 28, 2017:
The following 2 ASCIA documents are now available on the ASCIA website - new ASCIA-ANZAAG Chlorhexidine allergy information and updated ASCIA Guidelines for acute management of anaphylaxis for health professionals.
New ASCIA-ANZAAG Chlorhexidine (antiseptic agent) allergy information for patients, consumers and carers, was developed in conjunction with ANZAAG, the Australian and New Zealand Anaesthetic Allergy Group, and is available at www.allergy.org.au/patients/medication-allergy
Chlorhexidine is a highly effective antiseptic agent. Whilst allergic reactions to chlorhexidine are rare, they are increasing in frequency, which is possibly related to increased use of chlorhexidine containing products in recent years. Chlorhexidine is used in a large number of products and its presence can sometimes be ‘hidden’. As antibiotic resistant organisms are becoming more common, its use in both prevention and treatment of infection is likely to continue.
Updated ASCIA Guidelines for acute management of anaphylaxis (for health professionals) are available at www.allergy.org.au/health-professionals/papers/acute-management-of-anaphylaxis-guidelines These updated guidelines include:
- Advanced acute management information as an Appendix, which was previously in a separate document.
- Information about emergency treatment for anaphylaxis in patients with known asthma and severe allergies on page 1. This is the same information that has been on the ASCIA Action Plans for Anaphylaxis since 2016.
- Infographics that reinforce correct positioning of patients on page 1. These are the same infographics that have been on the ASCIA Action Plans for Anaphylaxis since 2016. Detailed information regarding positioning of patients is on page 2.
- Simplified adrenaline infusion and dose guidelines on page 2, under a new heading, “Adrenaline administration and dosages”.
- Advice on discharge procedures on page 4, under the revised heading, “Follow up treatment including advice for hospital discharge”.
November 23, 2017:
Mylan has advised that both EpiPen 300mcg and EpiPen Jr 150mcg adrenaline (epinephrine) autoinjectors have now been shipped to Australian pharmacy wholesalers and stock will become available to pharmacies shortly. The supply of no-charge EpiPen® Jr 150mcg, expiring 30 November 2017, has therefore ceased.
Further stock will be released over the coming weeks. Due to demand, orders will be filled as efficiently as possible, as they work to restore the supply.
November 14, 2017:
Bayer Australia Ltd (Bayer) has advised that they are experiencing a temporary shortage of Novalac Allergy rice protein based infant formula. This has resulted in very limited supply in pharmacies throughout Australia.
Bayer is working to increase the supply of Novalac Allergy to meet local requirements, and it is anticipated that stock will be available from pharmacies in early December 2017.
It is important to note that out of the Novalac range of infant formula, only Novalac Allergy is suitable for use in children diagnosed with cow’s milk protein allergy.
November 8, 2017:
Mylan Australia is experiencing a temporary shortage of EpiPen® Jr 150mcg adrenaline (epinephrine) autoinjectors. This supply disruption is due to an unforeseen delay in supply from the overseas manufacturer. In the meantime, to minimise the impact on patient care, Mylan has put a process in place to ensure those most at-risk have access to emergency supply.
Mylan Australia wishes to advise that they will be supplying eligible patients with an EpiPen® Jr, expiring on 30 November 2017, at no charge.
Requests will only be accepted for patients requiring an EpiPen® Jr before the end of the month and who do not have access to another in-date EpiPen® Jr. This is a temporary solution until regular supply returns to the Australian market.
Patients can obtain supply by contacting their pharmacy. Pharmacists should then contact the Mylan Customer Support team on 1800 274 276 to request an EpiPen® Jr (expiring on 30 November 2017) that will be supplied to the pharmacy and patient at no charge.
Patients will need to return to their pharmacy with their prescription to replace the EpiPen® Jr at the end of November. Mylan expects stock to be available mid-to-late November 2017.
ASCIA recommends EpiPen® Jr 150mcg for patients weighing between 10-20kgs and EpiPen® 300mcg for patients 20kgs and over.
Pharmacists with any issues regarding supply of EpiPen® Jr or EpiPen® should contact the Mylan Customer Support team on 1800 274 276.
Please note that New Zealand is not affected by this temporary shortage.
October 20, 2017:
Auspollen invites people with hay fever (allergic rhinitis) and/or asthma that is made worse by allergens in the air, to evaluate free local AusPollen Apps.
The Apps provide daily levels of pollen in the air and can be accessed on the AusPollen website www.pollenforecast.com.au or via iTunes, Google Play Apps, twitter and facebook.
To help evaluate usefulness of the AusPollen Apps and improve this service, please complete a short questionnaire before and after the pollen season. The questionnaire opens on October 20, 2017 and the link is http://survey.qut.edu.au/f/190401/43d7/)
This research will help us know where to locate future pollen count sites and determine if there are local triggers that make hay fever and asthma worse.
September 19, 2017:
The 28th ASCIA Annual Conference was held in Auckland, New Zealand at the Viaduct Events Centre from Wednesday 13th to Friday 15th September 2017. This conference was a great success, with more than 550 registrations, an outstanding program, an interactive conference app and a spectacular venue located on the stunning Waitematā Harbour in Auckland. The positive feedback received from delegates has indicated that it was a highlight of the year for ASCIA members and other health professionals with an interest in allergy and clinical immunology.
September 9, 2017:
September 5, 2017:
The ASCIA website listings for Allergy and Clinical Immunology Services in Australia and New Zealand have been significantly updated, to provide additional information in a more mobile/tablet responsive format. The updated lists of Full (Ordinary) ASCIA members working in private and/or public clinical practice are available at www.allergy.org.au/patients/locate-a-specialist
A referral from a GP is required for consultations, as the listed ASCIA members are all medical specialists.
September 4, 2017:
To coincide with National Asthma Week (1-7 September 2017) and the start of Spring, the new ASCIA Allergic Rhinitis Clinical Update for health professionals has been released. This document complements ASCIA allergic rhinitis e-training courses for health professionals and is available open access and free of charge on the ASCIA website:
This document includes important information asthma, thunderstorm asthma and a link to the recently updated ASCIA Treatment Plan for Allergic Rhinitis:
ASCIA allergic rhinitis e-training courses for health professionals are available free of charge on the ASCIA website:
Allergic rhinitis (hay fever) and asthma are often referred to as “United airway disease”. This is due to them being upper and lower respiratory tract manifestations of the same inflammatory process. For example, inhalation of aeroallergens through the nose may contribute to inflammation in lung. Allergic rhinitis is a risk factor for subsequent asthma development and effective treatment of allergic rhinitis improves asthma management.
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