Job description of an allergist-immunologist at a polyclinic. Children's allergist job description

An allergist-immunologist is a medical specialist who is engaged in the identification and treatment of various types of allergies associated with a disorder of the human immune system. The doctor is also developing preventive measures aimed at preventing the development of allergic pathologies.

An allergist-immunologist deals with the treatment and prevention of allergic reactions.

It is a well-known fact that various diseases appear as a result of a decrease in the protective functions of the body. This includes diseases such as allergies. Therefore, the doctor conducts therapy in two directions - treats allergies and strengthens the immune functions of the body.

Specialization has arisen relatively recently. The appearance is associated with the annual growth of patients who suffer from the occurrence of allergic reactions. According to statistics, every fifth person suffers from allergies, especially the children's body is prone to this. Therefore, the demand for the profession of an allergist-immunologist is growing.

What is the competence of an allergist-immunologist

The doctor reveals the causes of the disorder of the immune functions of the body and, as a result, the manifestation of allergic reactions. The primary competence of the doctor is to identify allergens that affect the violation of the patient's immunity, after which appropriate treatment is prescribed.

The efforts of an allergist-immunologist are aimed at preventing exacerbations of seasonal allergies

Important areas of work of a specialist are:

Diagnosis, preventive measures for bronchial asthma, dermatitis, various types of rhinitis, conjunctivitis, etc.
Appointment, as well as carrying out medical procedures aimed at eliminating seasonal and year-round allergies.
Diagnosis, therapeutic correction of immunity.
Carrying out restorative procedures aimed at protecting the human immune system.

To date, children's immunity is greatly weakened due to poor ecology. As a result, an allergist-immunologist often treats and strengthens the immune system of children and adults.

Diseases within the competence of an allergist-immunologist

The scope of the specialist includes the identification and treatment of the following diseases:

childhood atopic dermatitis caused by food allergies;
children's, adult contact and seborrheic dermatitis caused by skin contact with any reagent;
respiratory allergy caused by air allergens;
hay fever - an allergy provoked by plant allergens;
persistent allergic rhinitis (continuous runny nose with itching and redness);
children's and adult seasonal allergic rhinitis (runny nose caused by pollen);

The competence of the doctor treatment of allergic rhinitis

inflammation of the skin, including purulent acne;
allergic conjunctivitis;
children's urticaria;
intolerance to certain food groups (food allergy);
drug intolerance;
herpes;
angioedema;
chronic tonsillitis and other purulent diseases of the pharynx;
chronic lung disease caused by a decrease in the immune structure;
bronchial asthma - a severe disease of the respiratory tract of a chronic form;
relapses of diseases on an ongoing basis.

An allergist-immunologist should be consulted in case of food intolerance

A pediatric allergist-immunologist often treats lichen, hives, warts, atopic dermatitis caused by allergenic foods. Thus, an allergist-immunologist detects allergic reactions in the eyes, bronchi, nasopharynx, skin, nose and treats them.

In what cases it is necessary to contact a specialist

Consultation with an allergist-immunologist is necessary if the following symptoms are recorded in a patient:

recurrent or persistent nasal congestion;
persistent or seasonal runny nose;
redness, irritation, rash and inflammation on the skin;

Consultation with an allergist-immunologist is necessary for chronic difficulty in breathing

frequent irritation of the mucous membranes of the eyes and nose;
frequent sneezing and lacrimation;
breathing heard at a distance;
mouth breathing due to nasal congestion;
dry cough of a protracted nature;
frequent colds and SARS (more than three times a year);
the occurrence of herpes more than five times a year;
persistent bruising under the eyes;
shortness of breath, shortness of breath, suffocation caused by bronchial asthma;
frequent fever and dizziness of an incomprehensible nature.

The appearance of SARS more than 3 times a year is a reason to visit an allergist-immunologist

If the symptoms of a seasonal nature do not disappear within a week, and if the symptoms are chronic for more than four weeks, then an allergist-immunologist should be consulted.

What tests and diagnostic methods does the doctor use

To identify certain substances responsible for the development of diseases, it is necessary to collect the following tests:

Scraping from the affected skin.
Sputum analysis.
Blood test for antibodies.
Blood test for biochemistry.
Complete blood count (blood is taken from a vein).

To diagnose diseases, the doctor prescribes an immunological blood test.

Immunological diagnosis (determine the presence of antibodies in the blood).
Immunogram (blood is taken from a finger, after which the content of leukocytes and lymphocytes is determined in it).
Fecal analysis (determine the resistance of antibacterial drugs to the sensitivity of bacteria).
Analysis for HIV and STDs.
Allergen test (a possible allergen in a liquid state is planted on the skin, then swelling, redness of the affected area is observed).

Children's test for allergens is carried out according to the latest type of analysis. As diagnostic methods, an allergist-immunologist uses:

X-ray (it gives an assessment, determines if there is damage to internal organs).

One of the most effective methods for identifying allergens are allergy tests.

An appointment with an allergist-immunologist begins with a detailed questioning of the patient, consisting of the following list of questions:

What worries the patient?
When did the first symptoms appear?
Have you experienced similar symptoms before?

During the consultation, the allergist-immunologist examines the patient's medical history in detail

Under what conditions do symptoms worsen?
Have you tried self-treatment?
Does the reaction occur after eating certain foods?
Is there a hereditary predisposition to allergies?

After collecting an anamnesis, an examination of the mucous membranes and skin is carried out. To make a diagnosis and prescribe further treatment, an allergist-immunologist gives a referral for certain tests. If the cause of the disease is not identified, an x-ray examination of the affected area is performed.

To prevent the occurrence of allergic reactions, vitamin complexes should be taken in the off-season.

Review your daily routine.
Be sure the doctor advises to switch to proper nutrition. Avoid fried, spicy, salty foods.
In acute forms of diseases, allergy sufferers need to follow a certain diet. Refuse citrus fruits, red fruits and berries, which can provoke an increase in dermatological reactions.
Take vitamins A, B, C to restore immunodeficiency every spring and autumn.
Take dietary supplements to strengthen the immune system.
Add mandatory sports training to your daily routine. For example, swimming, running, daily walking.

Hardening will help strengthen children's immunity

Children's immunity is normalized by hardening. Therefore, gradually accustom the child to dousing with cold water.

If children often get colds, it means that children's immunity is reduced. In this case, an allergist-immunologist will help prevent the risk of complications.

Information about the diagnostic and treatment methods used by an allergist-immunologist is provided in the video:

1. General Provisions

1. This job description defines the job duties, rights and responsibilities of an allergist-immunologist.
2. A person with a higher medical education who has completed postgraduate training or specialization in the specialty "Allergology and Immunology" is appointed to the position of an allergist-immunologist.
3. An allergist-immunologist must know the basics of the Russian Federation legislation on health care; legal documents regulating the activities of healthcare institutions; the basics of organizing medical and preventive care in hospitals and outpatient clinics, emergency and emergency medical care, disaster medicine services, sanitary and epidemiological services, drug supply to the population and health care facilities; theoretical foundations, principles and methods of clinical examination; organizational and economic foundations for the activities of health care institutions and medical workers in the context of budgetary insurance medicine; fundamentals of social hygiene, organization and economics of healthcare, medical ethics and deontology; legal aspects of medical activity; general principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the human body; etiology, pathogenesis, clinical symptoms, course features, principles of complex treatment of major diseases; rules for the provision of emergency medical care; bases of examination of temporary incapacity for work and medico-social examination; fundamentals of health education; internal labor regulations; rules and norms of labor protection, safety measures, industrial sanitation and fire protection.
In his specialty, an allergist-immunologist should know modern methods of prevention, diagnosis, treatment and rehabilitation; content and sections of allergology and immunology as an independent clinical discipline; tasks, organization, structure, staffing and equipment of the allergic and immunological service; current legal and instructive and methodological documents in the specialty; rules for issuing medical documentation; the procedure for conducting an examination of temporary disability and medical and social examination; principles of activity planning and reporting of allergological and immunological services; methods and procedures for monitoring its activities.
4. An allergist-immunologist is appointed to the position and dismissed by the order of the head physician of the medical facility in accordance with the current legislation of the Russian Federation.
5. An allergist-immunologist reports directly to the head of the department, and in his absence, to the head of the health facility or his deputy.

2. Job responsibilities

Provides qualified medical care in his specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, permitted for use in medical practice. Determines the tactics of managing the patient in accordance with established rules and standards. Develops a plan for examining the patient, specifies the volume and rational methods of examining the patient in order to obtain complete and reliable diagnostic information in the shortest possible time. Based on clinical observations and examinations, anamnesis, data from clinical laboratory and instrumental studies, establishes (or confirms) the diagnosis, gives a clinical assessment of the patient's immune system. In accordance with the established rules and standards, prescribes and controls the necessary treatment, organizes or independently conducts the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and measures. The patient is examined daily in the hospital. Makes changes to the treatment plan depending on the patient's condition and determines the need for additional examination methods. Provides consultative assistance to doctors of other departments of health care facilities in assessing immunopathological disorders, in analyzing clinical cases that are difficult to diagnose and treat, identifying and analyzing the causes of discrepancies in data on the immune status obtained by various methods, when conducting clinical and pathomorphological examination. Supervises the work of secondary and junior medical personnel subordinate to him (if any), facilitates the performance of his duties. Controls the correctness of carrying out diagnostic and therapeutic procedures, the operation of instruments, apparatus and equipment, the rational use of reagents and drugs, compliance with safety and labor protection rules by middle and junior medical personnel. Participates in training sessions to improve the skills of medical personnel. Plans its work and analyzes the performance of its activities. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. Carries out sanitary-educational work. Complies with the rules and principles of medical ethics and deontology. Qualified and timely executes orders, orders and instructions of the management of the institution, as well as legal acts on his professional activities. Complies with the rules of internal regulations, fire safety and safety, sanitary and epidemiological regime. Promptly takes measures, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors. Systematically improves his skills.

An allergist-immunologist has the right to:
1. Establish an immunopathological diagnosis, determine methods for the correction and prevention of immunological disorders based on clinical observations and clinical and laboratory studies; determine the tactics of patient management in accordance with established rules and standards; prescribe the methods of instrumental, functional and laboratory diagnostics necessary for a comprehensive examination of the patient; carry out diagnostic, therapeutic, rehabilitation and preventive procedures using approved diagnostic and treatment methods; to involve, in necessary cases, doctors of other specialties for consultations, examination and treatment of patients;
2. to make proposals to the management of the institution on improving the diagnostic and treatment process, improving the work of administrative, economic and paraclinical services, issues of organization and conditions of their work;
3. control the work of subordinate employees (if any), give them orders within the framework of their official duties and demand their precise execution, make proposals to the management of the institution on their encouragement or imposition of penalties;
4. request, receive and use information materials and legal documents necessary for the performance of their duties;
5. to take part in scientific-practical conferences and meetings, which discuss issues related to his work;
6. pass certification in accordance with the established procedure with the right to obtain the appropriate qualification category;
7. to improve their qualifications at refresher courses at least once every 5 years.
An allergist-immunologist enjoys all labor rights in accordance with the Labor Code of the Russian Federation.

4. Responsibility

The allergist-immunologist is responsible for:
1. timely and high-quality implementation of the duties assigned to him;
2. organization of their work, timely and qualified execution of orders, instructions and instructions of the management, regulatory legal acts on their activities;
3. compliance with internal regulations, fire safety and safety;
4. timely and high-quality execution of medical and other service documentation provided for by the current legal documents;
5. providing, in accordance with the established procedure, statistical and other information on their activities;
6. Ensuring compliance with executive discipline and performance of their duties by subordinate employees (if any);
7. prompt action, including timely informing the management, to eliminate violations of safety, fire and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors.
For violation of labor discipline, legislative and regulatory legal acts, an allergist-immunologist can be brought in accordance with applicable law, depending on the severity of the misconduct, to disciplinary, material, administrative and criminal liability.

(professional standard "Doctor allergist-immunologist")

1. General Provisions

1.1. An allergist-immunologist belongs to the category of specialists.
1.2. To work as an allergist-immunologist, a person is accepted:
1) having a higher education - a specialist in the specialty "General Medicine" or "Pediatrics" and training in residency in the specialty "Allergology and Immunology" or training in internship and (or) residency in one of the specialties: "General medical practice (family medicine) ", "Pediatrics", "Therapy" and professional retraining in the specialty "Allergology and Immunology" or higher education - a specialist in the specialty "General Medicine", "Pediatrics" (for persons who have passed accreditation of specialists) and training in residency in the specialty "Allergology" and immunology";
2) having a certificate of a specialist or a certificate of accreditation of a specialist in the specialty "Allergology and Immunology";
3) who has passed mandatory preliminary (when applying for a job) and periodic medical examinations (examinations), as well as extraordinary medical examinations (examinations) in the manner established by the legislation of the Russian Federation;
4) not having restrictions on professional activities established by the legislation of the Russian Federation.
1.3. An allergist-immunologist should know:
1) the legislation of the Russian Federation and other legal acts regulating the procedures for conducting medical examinations, medical examinations, dispensary observation of patients with allergic diseases and (or) immunodeficiency states;
2) general issues of organizing medical care for the population;
3) issues of organizing sanitary and anti-epidemic (preventive) measures in order to prevent the occurrence and spread of infectious diseases;
4) the procedure for providing medical care, clinical recommendations (treatment protocols) on the provision of medical care to patients with allergic diseases and (or) immunodeficiency states;
5) standards of primary specialized health care, specialized, including high-tech, medical care for patients with allergic diseases and (or) immunodeficiency states;
6) patterns of functioning of a healthy human body and mechanisms for ensuring health from the standpoint of the theory of functional systems; features of the regulation of the functional systems of the human body in pathological processes;
7) a method for collecting anamnesis of life and complaints from patients (their legal representatives) with allergic diseases and (or) immunodeficiency states;
8) methods of examination and examination of patients with allergic diseases and (or) immunodeficiency states;
9) methods of laboratory and instrumental studies for assessing the state of health, medical indications for conducting studies, rules for interpreting their results in patients with allergic diseases and (or) immunodeficiency states;
10) the physiology of the immune system in patients in the norm, with diseases and (or) pathological conditions;
11) anatomical and physiological features of childhood and age-related evolution of allergic diseases;
12) etiology and pathogenesis, pathomorphology, clinical picture of differential diagnosis, course features, complications and outcomes of allergic diseases and (or) immunodeficiency states;
13) changes in the functioning of the immune system in other (infectious, autoimmune, oncological and other) diseases;
14) occupational diseases in allergology and clinical immunology;
15) methods of clinical and paraclinical diagnostics of allergic diseases and (or) immunodeficiency states;
16) medical indications and medical contraindications for skin tests with allergens and provocative tests with allergens in patients with allergic diseases;
17) allergic diseases and (or) immunodeficiency states requiring emergency medical care, referral of patients to medical specialists;
18) diseases and (or) conditions of other organs and systems, accompanied by changes in the functioning of the immune system;
19) international statistical classification of diseases and health-related problems (ICD);
20) symptoms and syndromes of complications, side effects, adverse reactions, including serious and unforeseen, resulting from diagnostic procedures in patients with allergic diseases and (or) immunodeficiency states;
21) clinical recommendations (treatment protocols) on the provision of medical care to patients with allergic diseases and (or) immunodeficiency states;
22) methods of treatment of patients with allergic diseases and (or) immunodeficiency states;
23) mechanisms of action of drugs, medical devices and clinical nutrition used in allergology and clinical immunology; medical indications and medical contraindications to the appointment; possible complications, side effects, adverse reactions, including serious and unforeseen;
24) methods of non-drug treatment of allergic diseases and (or) immunodeficiency states; medical indications and medical contraindications; possible complications, side effects, adverse reactions, including serious and unforeseen;
25) the mechanism of action of allergen-specific immunotherapy; medical indications and medical contraindications for use; methods of conducting; possible complications, side effects, adverse reactions, including serious and unforeseen;
26) medical indications and medical contraindications for vaccination in patients with allergic diseases and (or) immunodeficiency states, replacement therapy for patients with immunodeficiency states, possible complications, side effects, adverse reactions, including serious and unforeseen ones;
27) ways to prevent or eliminate complications, side effects, adverse reactions, including serious and unforeseen, that occurred during the examination or treatment of patients with allergic diseases and (or) immunodeficiency states;
28) aseptic and antiseptic requirements;
29) principles and methods of providing emergency medical care to patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
30) standards of medical care for allergic diseases and (or) immunodeficiency states;
31) the procedure for providing medical care to the population in the profile "allergology and immunology", the procedure for organizing medical rehabilitation;
32) the basics of medical rehabilitation for allergic diseases and (or) immunodeficiency states;
33) methods of medical rehabilitation for allergic diseases and (or) immunodeficiency states;
34) the mechanism of the impact of rehabilitation measures on the body in allergic diseases and (or) immunodeficiency states;
35) medical indications for referring patients with allergic diseases and (or) immunodeficiency conditions to specialist doctors for the appointment and implementation of medical rehabilitation measures, including the implementation of an individual rehabilitation and habilitation program for the disabled, the appointment and conduct of sanatorium treatment, including number in the implementation of individual;
36) the procedure for issuing certificates of incapacity for work, including in electronic form;
37) medical indications for referral of patients with persistent impairment of body functions due to allergic diseases and (or) immunodeficiency states for medical and social examination; requirements for the preparation of medical documentation;
38) rules for the execution of medical documentation in medical organizations providing medical care in the profile "allergology and immunology", including in electronic form;
39) rules for working in information systems and the information and telecommunications network "Internet";
40) labor protection requirements, basics of personal safety and conflict management;
41) official duties of medical workers in medical organizations of an allergological and immunological profile;
42) the methodology for collecting complaints and anamnesis from patients (their legal representatives);
43) methods of physical examination of patients (examination, palpation, percussion, auscultation);
44) clinical signs of sudden cessation of blood circulation and (or) respiration;
45) rules for conducting basic cardiopulmonary resuscitation;
46) ______________________________________.
1.4. An allergist-immunologist should be able to:
1) collect complaints, anamnesis of life in patients with allergic diseases and (or) immunodeficiency states;
2) interpret and analyze information received from patients (their legal representatives) with allergic diseases and (or) immunodeficiency states;
3) evaluate the functional state of the immune system in normal conditions, in diseases and (or) pathological conditions;
4) use the methods of examination and examination of patients with allergic diseases and (or) immunodeficiency states, taking into account age-related anatomical and functional features, in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care and standards of medical care, among which:
- Carrying out skin scarification and prick tests with allergens;
- carrying out intradermal tests with allergens;
- conducting a provocative sublingual test;
- conducting a provocative conjunctival test;
- conducting a provocative nasal test;
- peak flowmetry;
- study of the function of external respiration;
5) interpret and analyze the results of examination and examination of patients with allergic diseases and (or) immunodeficiency states;
6) substantiate and plan the volume of instrumental examination of patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
7) interpret and analyze the results of instrumental examination of patients with allergic diseases and (or) immunodeficiency states;
8) substantiate and plan the volume of laboratory examination of patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
9) interpret and analyze the results of laboratory examination of patients with allergic diseases and (or) immunodeficiency states;
10) justify the need to refer patients with allergic diseases and (or) immunodeficiency conditions to specialist doctors in accordance with the current clinical guidelines (treatment protocols) on the provision of medical care, procedures for the provision of medical care and taking into account the standards of medical care;
11) interpret and analyze the results of examination by medical specialists of patients with allergic diseases and (or) immunodeficiency states;
12) identify clinical symptoms and syndromes in patients with allergic diseases and (or) immunodeficiency states;
13) apply medical devices in accordance with the current procedures for the provision of medical, clinical recommendations (treatment protocols) on the provision of medical care, assistance, taking into account the standards of medical care;
14) determine medical indications for the provision of emergency, including emergency specialized, medical care to patients with allergic diseases and (or) immunodeficiency states;
15) identify symptoms and syndromes of complications, side effects, adverse reactions, including serious and unforeseen, resulting from diagnostic procedures in patients with allergic diseases and (or) immunodeficiency states;
16) develop a treatment plan for patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care for the population in the profile "allergology and immunology";
17) prescribe medicines, medical devices and medical nutrition to patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
18) evaluate the effectiveness and safety of the use of medicines, medical devices and clinical nutrition for patients with allergic diseases and (or) immunodeficiency states;
19) prescribe non-drug treatment to patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
20) evaluate the effectiveness and safety of non-drug treatment of patients with allergic diseases and (or) immunodeficiency states;
21) determine medical indications and medical contraindications for allergen-specific immunotherapy;
22) develop an individual protocol for allergen-specific immunotherapy for patients with allergic diseases;
23) monitor the efficacy and safety of allergen-specific immunotherapy for patients with allergic diseases;
24) determine medical indications and medical contraindications for vaccination in patients with allergic diseases and (or) immunodeficiency states;
25) draw up individual vaccination plans for patients with allergic diseases and (or) immunodeficiency states;
26) determine medical indications and medical contraindications for substitution therapy for patients with immunodeficiency states;
27) monitor the effectiveness and safety of substitution therapy for patients with immunodeficiency states;
28) perform manipulations:
- preparation of dilutions of individual allergens for allergen-specific immunotherapy;
- injections of allergens during allergen-specific immunotherapy;
- carrying out tests with medicines;
29) prevent or eliminate complications, side effects, adverse reactions, including serious and unforeseen, resulting from diagnostic or therapeutic manipulations, the use of drugs and (or) medical devices, non-drug treatment, allergen-specific immunotherapy;
30) monitor the disease and (or) condition, adjust the treatment plan depending on the characteristics of the course;
31) provide medical care to patients in emergency conditions caused by allergic diseases and (or) immunodeficiency states, in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care:
- stop acute angioedema;
- stop the exacerbation of asthma;
- provide medical care for anaphylactic shock;
- provide medical care for asthmatic status;
- stop the exacerbation of urticaria;
- stop the exacerbation of atopic dermatitis;
32) determine medical indications for medical rehabilitation measures for allergic diseases and (or) immunodeficiency states, including the implementation of an individual rehabilitation or habilitation program for disabled people, in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
33) develop an action plan for the rehabilitation of patients with allergic diseases and (or) immunodeficiency states, including the implementation of an individual program of rehabilitation or habilitation of the disabled, in accordance with the current procedure for organizing medical rehabilitation, procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
34) to carry out activities for the medical rehabilitation of patients with allergic diseases and (or) immunodeficiency states, including the implementation of an individual program of rehabilitation or habilitation of the disabled, in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care , subject to standards of medical care;
35) determine medical indications for referral of patients with allergic diseases and (or) immunodeficiency conditions to specialist doctors for the appointment and implementation of measures for medical rehabilitation and sanatorium treatment, including the implementation of an individual rehabilitation or habilitation program for disabled people, in accordance with current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
36) evaluate the effectiveness and safety of medical rehabilitation measures for allergic diseases and (or) immunodeficiency states, including the implementation of a rehabilitation or habilitation program for disabled people;
37) determine medical indications for referral of patients with persistent impairment of body functions due to allergic diseases and (or) immunodeficiency states for medical and social examination;
38) determine the signs of temporary disability and signs of persistent impairment of body functions caused by allergic diseases and (or) immunodeficiency states;
39) formulate medical opinions based on the results of a medical examination, medical examinations, including preliminary and periodic ones, in terms of the presence or absence of allergic diseases and (or) immunodeficiency states;
40) determine the indications for dispensary observation of patients with allergic diseases and (or) immunodeficiency states, the group of dispensary observation, its duration, the frequency of dispensary appointments (examinations, consultations), the scope of examination, preliminary, therapeutic measures in accordance with the procedure for providing medical care to patients with allergic diseases and (or) immunodeficiency states, clinical recommendations (treatment protocols), taking into account the patient's health status, stage, severity and individual characteristics of the course of the disease (condition);
41) identify conditions requiring emergency medical care, including clinical signs of a sudden cessation of blood circulation and respiration;
42) perform basic cardiopulmonary resuscitation activities;
43) provide emergency medical care to patients in conditions that threaten the lives of patients, including clinical death (stopping the vital functions of the human body (blood circulation and (or) respiration);
44) use medicines and medical devices in the provision of medical care in an emergency form;
45) ____________________________________.
(other skill requirements)
1.5. The allergist-immunologist in his work is guided by:
1) _____________________________________;
(name of constituent document)
2) Regulations on ____________________________;
(name of the structural unit)
3) this job description;
4) _____________________________________.
(names of local regulations governingjob functions by position)
1.6. Allergist-immunologist reports directly to
_____________________________________.
(name of the position of the head)
1.7. _________________________________.
(other general provisions)

2. Labor functions

2.1. Provision of medical care to the population in the profile "allergology and immunology":
2.1.1. Examination of patients in order to identify allergic diseases and (or) immunodeficiency states, to establish a diagnosis.
2.1.2. Prescribing treatment for patients with allergic diseases and (or) immunodeficiency states, monitoring its effectiveness and safety.
2.1.3. Carrying out and monitoring the effectiveness of medical rehabilitation for allergic diseases and (or) immunodeficiency states, including the implementation of individual programs for the rehabilitation and habilitation of disabled people.
2.1.4. Conducting medical examinations and medical examinations, medical examinations, dispensary observation in relation to patients with allergic diseases and (or) immunodeficiency states.
2.1.5. Analyzing medical and statistical information, maintaining medical records, organizing the activities of the medical staff at their disposal.
2.1.6. Providing emergency care to patients.
2.2. _____________________________.
(other features)

3. Job responsibilities

3.1. The allergist-immunologist performs the following duties:
3.1.1. As part of the labor function specified in paragraphs. 2.1.1 of this job description:
1) collects complaints, anamnesis of life in patients (their legal representatives) with allergic diseases and (or) immunodeficiency states;
2) examines patients with allergic diseases and (or) immunodeficiency states;
3) formulates a preliminary diagnosis and draws up a plan for laboratory and instrumental examinations of patients with allergic diseases and (or) immunodeficiency states;
4) refer patients with allergic diseases and (or) immunodeficiency states for instrumental examination in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
5) refer patients with allergic diseases and (or) immunodeficiency states for laboratory examination in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
6) refer patients with allergic diseases and (or) immunodeficiency states for a consultation with specialist doctors in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
7) establishes a diagnosis taking into account the current ICD;
8) carry out work to ensure the safety of diagnostic manipulations.
3.1.2. As part of the labor function specified in paragraphs. 2.1.2 of this job description:
1) develops a treatment plan for patients with allergic diseases and (or) immunodeficiency states, taking into account the diagnosis, age and clinical picture in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
2) prescribe medicines, medical devices and medical nutrition to patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
4) evaluates the effectiveness and safety of the use of medicines, medical devices and medical nutrition for patients with allergic diseases and (or) immunodeficiency states;
5) prescribes non-drug treatment: physiotherapy, reflexology, physical therapy and other methods of therapy - to patients with allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical guidelines (treatment protocols) on the provision of medical care, with taking into account the standards of medical care;
6) prescribe allergen-specific immunotherapy to patients with allergic diseases;
7) evaluate the effectiveness and safety of allergen-specific immunotherapy for patients with allergic diseases;
8) conducts vaccination in patients with allergic diseases and (or) immunodeficiency states;
9) evaluates the effectiveness and safety of non-drug treatment for patients with allergic diseases and (or) immunodeficiency states;
10) conducts prevention or treatment of complications, side effects, adverse reactions, including serious and unforeseen, resulting from diagnostic or therapeutic manipulations, the use of drugs and (or) medical devices, non-drug treatment, allergen-specific immunotherapy;
11) prescribe and select medical nutrition for patients with allergic diseases in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
12) provides medical care in emergency situations, including emergency situations, to patients with allergic diseases and (or) immunodeficiency states (anaphylactic shock, acute angioedema, status asthmaticus, exacerbation of asthma, acute urticaria, exacerbation of atopic dermatitis).
3.1.3. As part of the labor function specified in paragraphs. 2.1.3 of this job description:
1) draws up a plan of measures for medical rehabilitation for allergic diseases and (or) immunodeficiency states in accordance with the current procedure for organizing medical rehabilitation, procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
2) implements measures for the medical rehabilitation of patients with allergic diseases and (or) immunodeficiency states, including in the implementation of an individual rehabilitation and habilitation program for disabled people;
3) refer patients with allergic diseases and (or) immunodeficiency conditions to specialist doctors for the appointment and implementation of medical rehabilitation measures, sanatorium treatment, including the implementation of an individual rehabilitation or habilitation program for disabled people, in accordance with the current procedure for organizing medical rehabilitation , procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care;
4) evaluates the effectiveness and safety of medical rehabilitation measures for allergic diseases and (or) immunodeficiency states in accordance with the current procedures for the provision of medical care, clinical recommendations (treatment protocols) on the provision of medical care, taking into account the standards of medical care.
3.1.4. As part of the labor function specified in paragraphs. 2.1.4 of this job description:
1) performs work on carrying out certain types of examinations, medical examinations, including preliminary and periodic ones;
2) conducts an examination of temporary disability of patients with allergic diseases and (or) immunodeficiency states, works as part of a medical commission of a medical organization that performs an examination of temporary disability;
3) prepares the necessary medical documentation for patients with allergic diseases and (or) immunodeficiency conditions for the implementation of medical and social expertise in federal state institutions of medical and social expertise;
4) refer patients with persistent impairment of body functions caused by allergic diseases and (or) immunodeficiency states to undergo a medical and social examination.
3.1.5. As part of the labor function specified in paragraphs. 2.1.5 of this job description:
1) draws up a work plan and a report on his work;
2) maintains medical records, including in electronic form;
3) carry out anti-epidemic measures in the event of a focus of infection;
4) controls the performance of official duties by medical personnel at their disposal;
5) carries out work to ensure internal quality control and safety of medical activities;
6) use medical information systems and information and telecommunication network Internet;
7) uses in the work personal data of patients and information constituting a medical secret.
3.1.6. As part of the labor function specified in paragraphs. 2.1.6 of this job description:
1) assesses the condition of patients requiring emergency medical care;
2) recognizes conditions that pose a threat to the life of patients, including the state of clinical death (stoppage of vital functions of the human body (blood circulation and (or) respiration)), requiring emergency medical care;
3) provides emergency medical care to patients in conditions that threaten the lives of patients, including clinical death (stopping the vital functions of the human body (blood circulation and (or) breathing));
4) uses medicines and medical devices in the provision of medical care in an emergency form.
3.1.7. As part of the performance of their labor functions:
1) receives additional professional education (training programs and professional retraining programs);
2) forms professional skills through mentoring;
3) is undergoing an internship;
4) uses modern distance learning technologies (educational portal and webinars);
5) undergo training in simulation centers;
6) takes part in congresses, congresses, conferences, symposiums;
7) complies with the legislation of the Russian Federation in the field of health care, regulations, documents that determine the activities of medical organizations and medical workers, programs of state guarantees of free provision of medical care to citizens;
8) observes medical secrecy, doctor's oath, principles of medical ethics and deontology in work with patients, their legal representatives and colleagues.
3.1.8. ______________________________.
(other duties)
3.3. ________________________________.
(other job descriptions)

4. Rights

4.1. The allergist-immunologist of the organization has the right to:
4.1.1. Participate in the discussion of draft decisions of the organization's management, in meetings for their preparation and implementation.
4.1.2. Sign and endorse documents within their competence.
4.1.3. Ask the immediate supervisor for clarifications and clarifications on these instructions, issued assignments.
4.1.4. Request, on behalf of the immediate supervisor, and receive from other employees of the organization the necessary information, documents necessary for the execution of the assignment.
4.1.5. Get acquainted with the draft decisions of the management regarding the function performed by him, with documents defining his rights and obligations in his position, criteria for assessing the quality of the performance of his labor functions.
4.1.6. Demand the termination (suspension) of work (in case of violations, non-compliance with established requirements, etc.), compliance with established norms, rules, instructions; give instructions for correcting deficiencies and eliminating violations.
4.1.7. Submit proposals on the organization of labor within the framework of their labor functions for consideration by their immediate supervisor.
4.1.8. Participate in the discussion of issues related to the duties performed.
4.2. _____________________________.
(other rights)

5. Responsibility

5.1. Allergist-immunologist is responsible for:
- for improper performance or non-performance of their official duties provided for by this job description - in the manner established by the current labor legislation of the Russian Federation, accounting legislation;
- offenses and crimes committed in the course of their activities - in the manner prescribed by the current administrative, criminal and civil legislation of the Russian Federation;
- causing damage to the organization - in the manner prescribed by the current labor legislation of the Russian Federation.
5.2. _______________________________.
(other liability provisions)

6. Final provisions

6.1. This manual has been developed on the basis of the Professionalstandard "Doctor allergist-immunologist", approved by the Order of the Ministry of LaborRussia dated 14.03.2018 N 138n

______________________________________________.
(details of local regulations of the organization)
6.2. Familiarization of the employee with this instruction is carried out atemployment (before signing the employment contract).
The fact of familiarization of the employee with this instruction is confirmed
____________________________________________
(signed on the familiarization sheet, which is an integral part of
___________________________________________.
this manual (in the instruction book);
in a copy of the instructions kept by the employer; otherwise)
6.3. _________________________________________________________________.

Round tablets, white, biconvex film-coated.

Compound

Each tablet contains:

active substance: levocetirizine dihydrochloride - 5 mg;

Excipients: microcrystalline cellulose, lactose monohydrate, crospovidone, magnesium stearate, colloidal anhydrous silica.

shell composition: Opadry II 85F18422 white (polyvinyl alcohol, titanium dioxide (E 171), polyethylene glycol, talc).

Release form

Coated tablets.

Pharmacotherapeutic group

Antihistamine drugs of systemic action. Piperazine derivatives.

ATX code

Indications for use

In adults and children over 6 years of age, for the treatment of the following conditions:

allergic rhinitis, seasonal, year-round or persistent (hay fever, hay fever);
allergic conjunctivitis;
chronic idiopathic urticaria.

In children under 6 years of age, levocetirizine drops are recommended for the treatment of seasonal allergic rhinitis.

Dosage and administration

It is used orally with food or on an empty stomach, with a small amount of water, without chewing.

Adults and children over 6 years old: daily dose - 5 mg (1 tablet).

Patients with impaired renal function.

Patients may be given reduced doses individually, depending on the severity of renal dysfunction. The mode of reception should be determined by the doctor.

Children with impaired renal function

The dose should be set individually, taking into account the creatinine clearance and the patient's body weight. There are no specific data on children with impaired renal function.

Patients with impaired liver function. When prescribing the drug to patients with impaired liver function, no dose changes are required. Patients with combined impaired liver function of the kidneys are recommended to clarify the dose with the doctor.

Duration of taking the drug

With intermittent allergic rhinitis (presence of symptoms for less than 4 days a week for less than 4 weeks in a row), the duration of the course of treatment depends on the type, duration and symptoms. After the disappearance of symptoms, treatment can be stopped and resumed if they reappear

In persistent allergic rhinitis (with symptoms lasting more than 4 days a week for more than 4 weeks), continuous treatment is recommended as long as the patient has contact with allergens. Currently, there is clinical experience with the use of levocetirizine tablets for 6 months in adults with persistent allergic rhinitis.

If you have any doubts or questions, please contact your doctor.

Side effect

Clinical trial data

In clinical trials, adverse reactions were observed in 14.7% of patients receiving levocetirizine 5 mg, compared with 11.3% of patients in the placebo group. 95% of these adverse reactions were mild or moderate.

According to the results of therapeutic studies with levocetirizine 5 mg, 0.7% (4/538) of patients withdrew from the study due to adverse reactions, which was comparable to the frequency in the placebo group - 0.8% (3/382).

In clinical therapeutic studies of levocetirizine at a dose of 5 mg / day, a total of 538 patients took part. The safety summary of this medicinal product lists the following common adverse reactions:

Although drowsiness was more common in the levocetirizine group, it was mild to moderate compared to the placebo group.

In addition to the above adverse reactions, abdominal pain has been observed infrequently.

Experience in the post-marketing period

Metabolic and nutritional disorders: increased appetite;

mental disorder: anxiety, aggressiveness, agitation, hallucinations, depression, insomnia, suicidal thoughts;

Nervous System Disorders: convulsions, sinus thrombosis, paresthesia, vertigo, dizziness, fainting, tremor, impaired taste perception;

Violations of the organ of vision: inflammation, blurred vision, blurred vision;

Heart disorders: angina pectoris, palpitations, tachycardia;

Vascular disorders: jugular vein thrombosis;

Respiratory, thoracic and mediastinal disorders: increased rhinitis, respiratory distress;

Liver and biliary tract disorders: hepatitis;

Skin and subcutaneous tissue disorders: angioedema, fixed toxidermia, pruritus, skin rash, urticaria, hypotrichosis, fissures, photosensitivity / toxicity;

Musculoskeletal and connective tissue disorders: myalgia;

Renal and urinary tract disorders: urinary incontinence, urinary retention;

General disorders and disorders at the injection site: edema, drug inefficiency, dry mucous membranes, weight gain;

Influence on the results of laboratory and instrumental studies: cross reactivity.

Safety data from post-marketing monitoring of racemate cetirizine

There have been reports of the following side effects:

Rare (<1/1000 и ≥1/10000) :

Mild and transient side effects such as fatigue, difficulty concentrating, drowsiness, headache, dizziness (vertigo), agitation, dry mouth, and gastrointestinal disturbances (eg, constipation).

In some cases, hypersensitivity reactions were observed, accompanied by skin reactions and angioedema. In isolated cases, there have been reports of the development of seizures, photosensitivity reactions, liver damage, anaphylactic shock, circulatory failure, deafness, malaise, itching, vasculitis and visual impairment.

In the event of adverse reactions, including those not listed in this leaflet, you must stop taking the drug and consult a doctor.

Contraindications

Hypersensitivity to any of the components of the drug or piperazine derivatives. Severe form of chronic renal failure (creatine clearance less than 10 ml / min). Children's age (up to 6 years).

With caution - chronic renal failure (correction of the dosing regimen is required), old age (glomerular filtration rate may decrease).

The drug should not be used in patients with rare hereditary galactose intolerance, lactase deficiency (Lapp type) or glucose-galactose malabsorption syndrome.

Overdose

Symptoms: may be accompanied by signs of intoxication in the form of drowsiness; in children, an overdose of the drug may be accompanied by anxiety and increased irritability.

Treatment: if symptoms of an overdose appear (especially in children), the drug should be discontinued, gastric lavage, activated charcoal, symptomatic therapy is necessary. There is no specific antidote. Hemodialysis is not effective.

Precautionary measures

Prescribing the drug Allergoloc film-coated tablets is not recommended for children under the age of 6 years, since this dosage form does not allow you to properly adjust the dose. For children aged 2-6 years, levocetirizine is recommended to be used in a dosage form intended for children.

In patients with impaired renal function, the dose should be adjusted accordingly.

Concomitant use with alcohol requires caution, as this may cause increased drowsiness.

Particular caution should be exercised in patients with factors predisposing to urinary retention (eg, spinal cord injury or prostatic hyperplasia), as levocetirizine may increase the risk of urinary retention.

Use during pregnancy and lactation

Pregnancy

There are no data from clinical studies of levocetirizine during pregnancy. Studies conducted on animals have not revealed a direct or indirect toxic effect on the course of pregnancy, the development of the embryo or fetus. The potential risk to humans is unknown. Caution should be exercised when prescribing this medicinal product to pregnant women.

Breast-feeding

Levocetirizine should not be taken during breastfeeding as it is expected to pass into breast milk.

Influence on the ability to drive vehicles or potentially dangerous mechanisms

Levocetirizine may cause increased drowsiness, and therefore may affect the ability to drive vehicles or potentially dangerous machinery.

Interaction with other drugs

Interaction studies of levocetirizine with other medicinal products have not been conducted. Interaction studies of the racemic compound cetirizine did not reveal clinically significant adverse interactions (with pseudoephedrine, cimetidine, ketocanazole, erythromycin, azithromycin, glipizide and diazepam). A slight decrease in the clearance of cetirizine (16%) was observed after repeated administration of theophylline (400 mg once a day) and cetirizine at different doses. At the same time, theophylline excretion did not change with the simultaneous administration of cetirizine.

In a repeat dose study with ritonavir (600 mg twice daily) and cetirizine (10 mg/day), cetirizine exposure was increased by approximately 40% and ritonavir disposition was slightly altered (-11%) when co-administered with cetirizine.

The degree of absorption of levocetirizine is not reduced in the presence of food, but the rate of absorption is reduced.

After the end of treatment, the level of levocetirizine in blood plasma decreases with a half-life of about 8 hours. Allergic tests can be carried out again three days after drug withdrawal.

The simultaneous use of levocetirizine with alcohol or other drugs that inhibit the function of the central nervous system can lead to drowsiness, decreased concentration and work productivity, although the racemate of cetirizine has not been proven to potentiate the effect of alcohol (at a blood alcohol content of 0.5 g / l ).

Storage conditions

In a place protected from moisture and light at a temperature not exceeding 25 ºС.

Keep out of the reach of children.

Best before date

Do not use after the expiry date stated on the packaging.

Package

7, 10 or 14 tablets in a blister pack made of PVC film and aluminum foil.

One or two blister packs of 7, 10 or 14 tablets, together with instructions for medical use in a cardboard pack.

Three blister packs of 10 tablets, along with instructions for medical use in a pack of cardboard.

Regulations on the allergist-immunologist
1. General Provisions
An allergist-immunologist is a specialist with a higher medical education in the specialty "General Medicine" or "Pediatrics", who owns various methods for diagnosing and treating immunopathological conditions (allergic, autoimmune, immunodeficiency - of various origins), theoretical and practical knowledge in the field of immunology and immunopathology provided by the training program in accordance with the requirements of the qualification characteristics and received a certificate.

In its work, it is guided by these Regulations and other regulatory documents of the Russian Federation on public health issues. Directly reports to the head of the immunological center (laboratory, cabinet), and in his absence - to the head of the institution or his deputy for medical work. The appointment and dismissal of an allergist-immunologist is carried out in accordance with applicable law and the terms of the contract.

2. Responsibilities:
Participates in the management of the patient: taking into account the diagnostic algorithms, determines the plan for examining the patient, specifies the scope and rational research methodology in order to obtain complete and reliable diagnostic information in the shortest possible time, gives a clinical assessment of the patient's immune system.
Organizes or independently conducts the necessary diagnostic studies with the interpretation of their results. Carries out advisory work on assessing the role of immunopathological disorders in the development of emergency conditions, when analyzing clinical cases that are difficult to diagnose and treat, identifying and analyzing the causes of discrepancies in data on the immune status obtained by various methods, when conducting clinical and pathomorphological examination.
2.4. Performs practical work on outpatient (inpatient) management of patients in specialized medical institutions or conducting immunoassays in the relevant centers (laboratories).
2.5. Ensures the safety of the patient during research and the implementation of medical procedures.
2.6. Controls the correctness of diagnostic and therapeutic procedures, operation of equipment and equipment, rational use of reagents and drugs, compliance with safety and labor protection rules.
2.7. Prepares medical documentation of the established form and in accordance with the requirements of the Ministry of Health and Medical Industry of Russia.
2.8. Improves his/her qualifications in improvement cycles at least once every five years.

3. Rights of an allergist-immunologist An allergologist-immunologist has the right to:
1. Establish an immunopathological diagnosis; determine methods of correction and prevention of immune disorders based on clinical observations and clinical and laboratory studies.
2. To supervise the work of secondary and junior medical personnel subordinate to him.3. Take part in meetings, scientific and practical conferences, be a member of various public and professional organizations.
4. Responsibility of an allergist-immunologist.

An allergist-immunologist bears administrative and legal responsibility for errors in the management of patients that entailed serious consequences, for non-compliance with safety regulations during research or the implementation of therapeutic measures.