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Doctorevan.com

PATIENT INFORMATION 
Sublingual (under the tongue) and skin allergy testing are done in this office. Allergy testing is a
method to test for allergic antibodies. A skin test consists of introducing small amount of the
suspected substance, allergen, into the skin and recording the response 20 minutes after
application. A positive reaction consists of a wheal (swelling) and flare (surrounding area of
redness). Interpreting the clinical significance of the skin test requires correlation of the test
results with the patient’s clinical history. For the sublingual allergy test, liquid drops of allergic
substances are placed under the tongue and the patient is observed for any symptoms or signs
of a reaction.
PROCEDURE 
The Prick skin test method is used for identifying inhaled allergens. These include trees,
grasses, weeds, molds, dust mites, danders, etc. The skin testing appointment takes
approximately 45-60 minutes. Prick-puncture test will be performed on your arms and back (if
necessary). If you have a specific allergic sensitivity to an allergen, a red, raised itchy hive
(caused by histamine release into the skin) appears on your skin within 15-20 minutes. These
positive reactions, which will itch, will gradually disappear over 30-60 minutes, and typically, no
treatment is necessary. Occasionally local swelling at the test site will begin 4 to 8 hours after
the skin tests. These reactions are not serious and will gradually disappear over the next week
or so.
The sublingual allergy test is used for identifying food allergies. These include corn, egg, milk,
soy, wheat, yeast, cane, coconut and beet. Three drops of an allergen are placed under the
tongue, held for 10 seconds, then swallowed. Symptoms are then observed for 10 minutes and
then neutralized with successive dilutions. The dilution that neutralizes any symptoms is the
treatment dose.
MEDICATIONS YOU NEED TO STOP BEFORE TESTING: 
PLEASE READ CAREFULLY. FAILURE TO COMPLY CAN CAUSE INACCURATE TESTING

Antihistamines block the histamine response making the test inaccurate.
• NO over-the-counter antihistamines should be used 5 days prior to the scheduled
testing. These include cold tablets, sinus tablets, hay fever medications, oral treatments
for itchy skin, and over-the-counter sleeping medicines. Prescription antihistamines need
to be stopped 7 days prior to the test.

Over the counter (stopped 5 days prior to the test):
Actifed, Dristan, , Alavert, Drixoral, Benadryl, Rondec, Claritin, Tavist, Dimetapp,
Trinalin
Prescription (stopped 7 days prior to the test):
AlleRx-D, Phenergan, , Astelin Nasal Spray, Zyrtec, Allegra (5 days), Clarinex, AlleRx,
Histussin HC


• Medications, such as over-the-counter sleeping medicines (e.g., Nytol, Nyquil, and
Tylenol PM
) should be stopped 5 days before tests.
• Certain prescribed drugs have antihistaminic activity and should be stopped at least
2 weeks prior to tests. These include amitriptyline hydrochloride (Elavil),
hydroxyzine (Atarax), doxepin (Sinequan), imipramine (Tofranil), Remeron,
meclizine (Antivert),
and others. Please make the doctor and medical staff aware of all
the medications you are taking so that you may be advised if and when and how long you
should stop taking them prior to testing.
• Please let the medical staff know if you are taking a beta blocker, such as Inderal,
Lopressor, Tenormin
, and other. Do not take a beta blocker the morning of your
test.
• Please let the medical staff know if you are taking an antidepressant or monoamine
oxidase inhibitor.
Anti-inflammatories and Supplements to Avoid for 4 Days prior to testing:
• Aspirin (only take Tylenol)
• Ibuprophen
• Any other anti-inflammatory medications (like Naproxyn) • Do not take any Vitamin C 4 days before your testing date if over 240 mg.
On the Day of Testing:
• Do not wear perfume, hairspray, heavily-perfumed makeup, scented deodorants or
• scented lotions on day of testing. The clothes to be worn on the day of testing need to be • washed in a fragrance free laundry detergent and hung to dry. Failure to comply will result in your appointment being cancelled. • Do not smoke or chew gum or mints during testing. • Do not bring coffee, soda, or juice to drink during testing. Water is the only drink • Do not bring small children with you unless they are being tested. • Do not bring newspapers, new magazines with perfume ads, or newly printed books into • Do wear a short sleeved shirt on the day of testing. • Pain medications, tranqualizers, sleeping pills, and antibiotics are allowed. • Do eat a good breakfast/lunch before you come in. • Baby Aspirin okay. If you have any questions about any medicines after you get home today, please email to inquire about specific medications. MEDICATIONS YOU MAY CONTINUE 
• Continue on your intranasal allergy sprays such as (Atrovent, Beconase, Flonase,
Nasacort, Nasalide, Nasarel, Nasonex, and Rhinocort) except Astelin.
• Afrin or Sudafed made be used temporarily, but not the day of testing.
• Continue asthma inhalers (albuterol [Proventil, Ventolin], Advair, Aerobid, Alupent,
Atrovent, Azmacort, Brethaire, Flovent, Foradil, Intal, Maxair, Pulmicort, QVAR, Serevent,
Tilade), and oral theophylline (Uniphyl, Theo-24). They do not interfere with testing
and should be used as prescribed. ** Fasting is not necessary, and please avoid sunburns for one week before testing. Please let the physician and the medical staff know: a) If you are pregnant b) If you have a fever or are wheezing c) ALL medications you are taking (bring a list) ADVERSE REACTIONS 
A physician is present during testing since occasional reactions may require therapy. These
reactions may consist of any of the following symptoms: itchy eyes, nose, or throat; nasal
congestion; runny nose; tightness in the throat or chest; increased wheezing; light headedness;
faintness; nausea and vomiting; hives; generalized itching; and shock, the latter under extreme
circumstances. A severe reaction to testing has never occurred in this office, however, if one
would occur, the staff is trained to treat you. A separate follow-up appointment will be scheduled
and your physician will make further recommendations regarding your treatment.
WE REQUEST THAT YOU DO NOT BRING SMALL CHILDREN WITH YOU WHEN
YOU ARE SCHEDULED FOR SKIN TESTING UNLESS THEY ARE ACCOMPANIED
BY ANOTHER ADULT WHO CAN SIT WITH THEMIN THE RECEPTION AREA.

ANY ONE 17 YEARS OF AGE OR YOUNGER, MUST BE ACCOMPANIED BY A
PARENT OR LEGAL GUARDIAN DURING THE ENTIRE PROCEDURE AND VISIT
WITH THE PHYSICIAN.

SIGNED CONSENT 
I have read the patient information form on allergy testing and understand it. The opportunity
has been provided for me to ask questions regarding the potential side effects of allergy testing
and these questions have been answered to my satisfaction. I understand that every precaution
consistent with the best medical practice will be carried out to protect me against any reaction to
testing.
_____________________________________
PATIENT
_____________________________________ _______________________________ PATIENT _____________________________________ _______________________________ PARENT or LEGAL GUARDIAN (SIGNED) As parent or legal guardian, I understand that I must accompany my child throughout the entire procedure and visit.

Source: http://doctorevan.com/Allergy.pdf

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