Palforzia is a peanut allergen powder given orally in increasing doses for peanut allergy desensitization.
Peanut allergen powder
Palforzia is a peanut allergen powder given orally in increasing doses for peanut allergy desensitization. The goal is to minimize an allergic reaction to an accidental exposure. It is an alternative to peanut oral immunotherapy. This treatment is for daily use, must be continued indefinitely and individuals should still follow a peanut free diet. This specialty med comes at a price of $890 a month. If 3 doses are missed, then patients may need to restart the increasing doses all over.
HIV at any age
Everyone thinks of HIV differently; some can be in a committed relationship and believe this topic doesn’t relate to them, some don’t believe it will happen to them because they have sex with “clean and nice” partners, some take precautions such as condoms and Prep, while others don’t give HIV a thought.
A few months ago, my infectious disease colleague shared with me that she had to tell a 72 year patient that she was HIV positive! This patient was currently widowed having only one partner in her lifetime, her husband, who died 5 years earlier. This scenario is a sad one, but reality is that HIV can affect anyone, at any age, and in any relationship.
HIV
Unfortunately, in 2020 there are still individuals dying from AIDS in their 20s. There are amazing treatments that can allow individuals with HIV to live for years with an undetectable viral load, yet some individual chose to not follow up with their infectious disease providers or to take the medication regimen for various reasons. One of the most common reasons is denial. As a neurology NP I see this in the hospital more than I expected to with the availability to HIV programs and patient assistance programs for medication in my community.
What types of programs are available in your area for individuals that have HIV?
anaphylaxis
Anaphylaxis can be broken down into four subtypes; immunologic, nonimmunologic, idiopathic, and exercised induced. Idiopathic anaphylaxis (IA) is life threatening and can be fatal allergic disease if not identified and managed. Symptom of include urticaria, pruritus, angioedema, nausea, vomiting, wheezing, stridor, upper and lower airway obstruction, hypertension, and shock often resulting in a misdiagnosis (Chan & John, 2019). IA tends to present in females more than males suggesting a relation of estrogen/progesterone effect. Children present with respiratory symptoms, whereas, adults present with cutaneous symptoms (Chan & John, 2019). Symptoms of anaphylaxis can become fatal regardless of symptoms onset. Providers should be suspicious of IA after a patient has had two or more documented events of anaphylactic shock with no particular cause. Individual should be referred to an allergy/immunology specialist. Nonsteroidal anti- inflammatory drugs, latex, and angiotensin-converting enzyme inhibitor can be a trigger of IA. Management of IA is similar to other types of anaphylaxis; IM epinephrine, H1 & H2 antihistamines, systemic glucocorticoids & transport to ED for further monitoring and treatment.
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