Allergen extracts skin tests
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Solutions containing individually packed standardised allergen extracts
Drugs List
Therapeutic Indications
Uses
Allergy - diagnosis of allergen sensitivity
Dosage
Adults
Place one drop of each of the required test solutions on previously marked areas of skin on the volar surface of the forearm. The sites should be at least 4 centimetres apart. Puncture with a needle or blood lancet through the test solution. There should be no bleeding.
Blot excess fluid from the arm, taking care not to cross contaminate the test sites.
The tests should be accompanied by a negative result to a control test with the solvent used for the extracts. A positive result to a test with histamine solution may also be used.
The definitive test result is read after the time recommended by the manufacturer (10 to 15 minutes). A positive reaction presents as a pale wheal with a surrounding halo of red.
Elderly
(See Dosage; Adult)
Children
Depending on the condition of the patient, prick testing is feasible from the age of one year but in general it should not be performed before the age of 4.
Children over 1 year
(See Dosage; Adult)
Additional Dosage Information
In conditions of extreme outdoor temperatures allow acclimatisation of the skin to room temperature.
If the test area has been cleaned with water, alcohol etc, wait at least two minutes to allow skin circulation to return to normal.
Contraindications
Children under 1 year
Precautions and Warnings
Pregnancy
Children aged 1 to 4 years Have available adrenaline injection 1:1000 for anaphylaxis Observe patient for at least 30 minutes following administration Instruct patient not to rub or scratch test site Advise patient of the risk of late onset adverse reactions Avoid areas with skin lesions Beta blockers may reduce the response to adrenaline in anaphylaxis Treatment to be initiated and supervised by a specialist Discontinue short-acting antihistamines 2-3 days before test Discontinue long-acting antihistamines 8 weeks before test Discontinue hydroxyzine or ketotifen 2 weeks before test Discontinue tricyclic antidepressants 2 weeks before test Discontinue topical potent steroid ointment 2-3 weeks before test Some manufacturers suggest that use in patients with atopic dermatitis may hamper the reliability of the test.
Pregnancy and Lactation
Pregnancy
Skin prick testing solutions are not recommended in pregnancy, although some manufacturers note that skin prick testing solution is not an absolute contraindication in pregnancy.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Lactation
Skin prick tests may be carried out in breastfeeding.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Side Effects
Irritation (localised) Swelling(localised) Rhinitis Urticaria Anaphylactic shock Anaphylactic reaction Allergic reaction Conjunctivitis Angioedema Asthma
Bronchospasm
Wheezing
Application site reaction; Continuously increasing diameter of the wheal, cell shape changes (pseudopodia), diffuse swelling (delayed reaction)
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: September 2016
Reference Sources
Summary of Product Characteristics: Alternaria alternata 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: B2 Grass Pollens 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: B3 Tree Pollens 2.5% w/v Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: B5 Weeds and Shrub Pollen 2.5% w/v Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: Birch Pollen (Betula spp) 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: Cat Fur 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: Clad. Cladosporioides 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: D. farinae 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: D. pteronyssinus 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised February 2013.
Summary of Product Characteristics: Dog Hair 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: Egg Whole 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised February 2013.
Summary of Product Characteristics: Hazel Pollen (Corylus spp) 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: Horse Hair 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: Milk 50% w/v Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: Nettle Pollen (Urtica dioica) 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: Plantain Pollen (Plantago lanceolata) 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
Summary of Product Characteristics: Poplar Pollen (Populus spp) 10,000 DU/ml ODC Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised July 2015.
Summary of Product Characteristics: Soluprick SQ Grass Pollen Phleum pratense (Timothy Grass) 10 HEP. ALK Abello. Revised August 2010.
Summary of Product Characteristics: Soluprick SQ Animal Hair and Dander Felis domesticus (Cat Hair) 10 HEP solution for skin prick test. ALK-Abello A/S. Revised July 2010.
Summary of Product Characteristics: Soluprick SQ Animal Hair and Dander Canis familiaris (Dog Hair) 10 HEP solution for skin prick test. ALK-Abello A/S. Revised July 2010.
Summary of Product Characteristics: Soluprick SQ Animal Hair and Dander Equus caballus (Horse Dander) 10 HEP solution for skin prick test. ALK-Abello A/S. Revised September 2007.
Summary of Product Characteristics: Soluprick SQ House Dust Mite Dermatophagoides farinae 10 HEP solution for skin prick test. ALK-Abello A/S. Revised September 2007.
Summary of Product Characteristics: Soluprick SQ House Dust Mite Dermatophagoides pteronyssinus 10 HEP solution for skin prick test. ALK-Abello A/S. Revised June 2010.
Summary of Product Characteristics: Soluprick SQ Tree Pollen Betula verrucosa (Silver Birch) 10 Hep solution for skin prick test. ALK-Abello A/S. Revised June 2010.
Summary of Product Characteristics: Soluprick SQ Weed Pollen Artemisia vulgaris (Mugwort), 10 HEP solution for skin prick test. ALK-Abello A/S. Revised September 2007.
Summary of Product Characteristics: Wheat Grain 10% w/v Solution for skin prick test. Allergy Therapeutics (UK) Ltd. Revised September 2005.
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