Best Advice From an Allergist and Immunologist Specialist

Epinephrine

"Use epinephrine early and often," was the message from Dr. John Oppenheimer, an allergist and immunologist from UMDNJ. I recently had the pleasure of hearing Dr. Oppenheimer speak and I was struck by a story he shared. He told us that his wife asked him why he often shouts into the phone, "Use it! Use it now!" That's the urgent plea from Dr. Oppenheimer when a parent or school nurse calls his on-call service wondering if they should use an epinephrine auto-injector for someone they suspect may be having an allergic reaction.  

"Use it" means "administer epinephrine now".

I've been there. When my child has said, "My mouth feels itchy", or "I'm getting a hive on my lip," I've grabbed the bottle of Benadryl in one hand and the epinephrine in the other and watched closely. Who wants to stick a needle in a child and call an ambulance unless it's absolutely necessary?

According to Dr. Oppenheimer, use of epinephrine early in the anaphylaxis state may diminish the effect of late-stage anaphylaxis. He said that anaphylaxis is under-diagnosed and under-treated and he made it clear that the first line of defense is epinephrine, not an antihistamine, when an anaphylactic reaction is starting.

He shared that the triggers for anaphylaxis are Food (33% of the time), Unknown (25%), Insect (19%), Medications (14%), Other (9%, includes cat dander, latex, cleaning agents, etc.). 

For me, Dr. Oppenheimer's talk was another good reminder. One quarter of the time, an anaphylactic reaction has an unknown cause. An antihistamine is not effective at halting anaphylaxis. While no one wants to use an epinephrine injector, it is our best defense against anaphylaxis.

It is comforting to be able to reach an on-call doc in a moment of uncertainty and panic. Call your doctor if you have the time. If not, talk to your doctor now, so you have a plan in place if an anaphylactic reaction occurs. 

Food Allergy Alert- Recall of Allergy Medications

This is getting tiresome and time consuming, but there has been another recall of medications that may affect the allergy community. All Benadryl Fastmelt products, as well as Jr. Motrin, have been recalled by McNeil Consumer Healthcare.

Go check your medicine cabinet and then check here for details of the recall.



For a food allergy reaction, the Fastmelt tablets are not ideal. The liquid form of Benadryl is recommended. Consider the Benadryl pre-filled spoons- we keep one of these in the Epi-Pen waistpouch- for quick and easy use.

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Don't forget to support FAAN’s bid to win grants from the Pepsi Refresh Project for Fund a Cure for Life-Threatening Food Allergies.
There are three ways to vote through Dec. 31:

1. Vote on the Pepsi Refresh Website:
2. Text 104004 to Pepsi (73774)
3. Vote on Facebook with the Pepsi Refresh app

Tofutti Cutie and other Updates

I spoke to Steve Cass at Tofutti Cuties about the allegations of dairy contamination in their non-dairy frozen treats. He said, "These allegations are at least three years old and one of the plants involved in the allegation has been closed for quite some time."

When I asked about dedicated lines and regular testing, Steve said, "Tofutti Cuties are run on dedicated lines and tested DAILY for dairy."

Let's see what ELL finds in their independent test.

I contacted Sara Lee when I noticed that their Hearty and Delicious 100% Multi-grain Bread (quite delicious, by the way) listed milk on some labels, but not on others. I was told to trust the label. Their breads are made in different locations so some may contain, or be contaminated, with milk. The nutrition label on their website lists milk and is manufactured in Illinois. Hmmm...I didn't buy another loaf. My comfort level isn't there right now.

Nothing back from Zyrtec, Benadryl or Singulair about dairy in their medications. I sent e-mails, but I'll have to follow up with phone calls.

More to come...