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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/28285065/pharmacist-use-of-the-electronic-medical-record-to-identify-adults-at-risk-for-anaphylaxis-without-epinephrine-for-self-administration
#1
Autumn Stewart, Katherine Sulkowski
OBJECTIVES: To describe an innovative pharmacist-led approach, with the use of electronic medical record (EMR) data, to identify patients at risk of anaphylaxis in need of epinephrine auto-injector (EAI) for self-administration. SETTING: An urban free health care center for an uninsured indigent adult population in Pittsburgh, PA. PRACTICE INNOVATION: In this pilot service, patients with allergy history fields containing the words "anaphylaxis," "nut," "bee," or "shellfish" were screened for inclusion...
March 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28265481/anaphylaxis-in-schools-results-of-the-epipen4schools-survey-combined-analysis
#2
Martha V White, Susan L Hogue, Dawn Odom, Darryl Cooney, Jennifer Bartsch, Diana Goss, Kelly Hollis, Christopher Herrem, Suyapa Silvia
A pilot survey described the characteristics of anaphylactic events occurring in an initial set of participating U.S. schools during the 2013-2014 school year. This survey was subsequently readministered to large school districts, which were underrepresented in initial results. A cross-sectional survey was administered to the U.S. schools that were participating in the EPIPEN4SCHOOLS(®) program (Mylan Specialty L.P., Canonsburg, PA) to assess characteristics of anaphylactic events. Data from large school districts were added to initial findings in this comprehensive combined analysis...
September 1, 2016: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/28255796/acute-myocardial-infarction-in-a%C3%A2-patient-suffering-from-penicillin-induced-laryngeal-edema-kounis-syndrome-aggravated-by-adrenaline
#3
Mahmut Yesin, Macit Kalçık, Mustafa Ozan Gürsoy, Süleyman Karakoyun, Metin Çağdaş, Mehmet Özkan
Kounis syndrome or allergic angina is defined as the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classical angina pectoris. It is triggered by the action of potent vasoactive and inflammatory mediators, which are released from the mast cells during the allergic reaction. Epinephrine is a life-saving medication in anaphylaxis; however, it can aggravate ischemia and induce coronary vasospasm and arrhythmias. Here, we present a patient with Kounis syndrome that was caused by intramuscular injection of procaine penicillin G, and in whom epinephrine administration for treatment of laryngeal edema had provoked severe myocardial ischemia...
March 2, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28226324/a-survey-of-self-reported-food-allergy-and-food-related-anaphylaxis-among-young-adult-students-at-kuwait-university-kuwait
#4
Fatima Ali
OBJECTIVES: To conduct a survey on self-reported food allergy to milk, egg, peanuts, tree nuts, fish, shellfish, wheat and sesame as well as reported food-related anaphylaxis and epinephrine prescription practices among Kuwaiti students attending Kuwait University. SUBJECTS AND METHODS: One thousand (1,000) questionnaires that included data on age, gender, presence of food allergies and associated details were distributed. All participants reporting an allergy were categorized as having a perceived food allergy...
February 22, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28215605/the-high-cost-of-epinephrine-autoinjectors-and-possible-alternatives
#5
Amber N Pepper, Emma Westermann-Clark, Richard F Lockey
Epinephrine autoinjectors provide potentially life-saving therapy for pediatric and adult subjects with systemic allergic reactions, including anaphylaxis. However, the cost of these devices, specifically the EpiPen (Mylan, Canonsburg, Pa), is increasing exponentially. Epinephrine autoinjectors are commonly prescribed in the United States but are not readily available worldwide. Alternatives for the self-administration of epinephrine exist and should be considered for patients who cannot afford or do not have access to these devices...
February 10, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28193793/guidance-on-completing-a-written-allergy-and-anaphylaxis-emergency-plan
#6
Julie Wang, Scott H Sicherer
Anaphylaxis is a potentially life-threatening, severe allergic reaction. The immediate assessment of patients having an allergic reaction and prompt administration of epinephrine, if criteria for anaphylaxis are met, promote optimal outcomes. National and international guidelines for the management of anaphylaxis, including those for management of allergic reactions at school, as well as several clinical reports from the American Academy of Pediatrics, recommend the provision of written emergency action plans to those at risk of anaphylaxis, in addition to the prescription of epinephrine autoinjectors...
February 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28193791/epinephrine-for-first-aid-management-of-anaphylaxis
#7
Scott H Sicherer, F Estelle R Simons
Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28117270/food-allergic-adolescents-at-risk-for-anaphylaxis-a-randomized-controlled-study-of-supervised-injection-to-improve-comfort-with-epinephrine-self-injection
#8
Eyal Shemesh, Christine D'Urso, Christopher Knight, Melissa Rubes, Kinga M Picerno, Ailie M Posillico, Zara Atal, Rachel A Annunziato, Scott H Sicherer
BACKGROUND: Epinephrine self-injection is a key element in the management of food allergy, yet many adolescents report that they may not be able to use the autoinjector when needed. We hypothesized that supervised self-injection with an empty syringe would increase adolescents' comfort with self-injection. OBJECTIVE: The objective of this study was to examine the effect of supervised self-injection on self- and parent-reported comfort and anxiety during and after clinic visits in a food allergy center...
January 20, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28115856/anaphylaxis-across-two-canadian-pediatric-centers-evaluating-management-disparities
#9
Alison Ym Lee, Paul Enarson, Ann E Clarke, Sébastien La Vieille, Harley Eisman, Edmond S Chan, Christopher Mill, Lawrence Joseph, Moshe Ben-Shoshan
BACKGROUND: There are no data on the percentage of visits due to anaphylaxis in the emergency department (ED), triggers, and management of anaphylaxis across different provinces in Canada. OBJECTIVE: To compare the percentage of anaphylaxis cases among all ED visits, as well as the triggers and management of anaphylaxis between two Canadian pediatric EDs (PEDs). METHODS: As part of the Cross-Canada Anaphylaxis Registry (C-CARE), children presenting to the British Columbia Children's Hospital (BCCH) and Montreal Children's Hospital (MCH) EDs with anaphylaxis were recruited...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28069483/epinephrine-use-in-older-patients-with-anaphylaxis-clinical-outcomes-and-cardiovascular-complications
#10
Takahisa Kawano, Frank Xavier Scheuermeyer, Robert Stenstrom, Brian H Rowe, Eric Grafstein, Brian Grunau
BACKGROUND: There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. METHODS: This retrospective cohort study was conducted at two urban emergency departments (ED) over a 5 year-period, and included adults who met a pre-specified criteria for anaphylaxis. Patients ≥50years of age were defined as "older". Univariate logistic regression was performed to compare the difference in frequency of epi administration between the "older" and "younger" groups...
January 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28052801/factors-that-determine-parents-perception-of-their-child-s-risk-of-life-threatening-food-induced-anaphylaxis
#11
Jennifer Ogg, Jayne Wong, Ming Wai Wan, Naomi Davis, Peter D Arkwright
BACKGROUND: Although food allergy is known to be associated with increased disease burden, factors that shape parents' perception of their child's risk of future severe or fatal anaphylaxis are poorly understood. OBJECTIVE: This study aimed to evaluate factors associated with parents' perceived risk of food-induced anaphylaxis. METHODS: A questionnaire-based survey of 202 parents was conducted in a single specialist center outpatient clinic that treats children with food allergies...
January 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27999602/anaphylaxis-to-supplemental-oral-lactase-enzyme
#12
M R Voisin, R Borici-Mazi
BACKGROUND: Anaphylactic reactions involving IgE mediated hypersensitivity have been frequently reported for a number of uncommon foods. However, cases of anaphylaxis to over the counter vitamins and oral supplements have been rarely published. Lactose intolerance affects approximately 20% of Canadians and roughly 70% of the world's population of any age. Lactose intolerance develops primarily due to the absence of the enzyme lactase and treatment involves avoidance of lactose-containing foods or ingestion of commercially available lactase enzyme preparations prior to their consumption...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27992679/incomplete-and-incorrect-epinephrine-auto-injector-training-to-food-allergic-patients-by-pharmacists-in-the-netherlands
#13
J Saleh-Langenberg, S de Vries, E Bak, B J Kollen, B M J Flokstra-de Blok, A E J Dubois
BACKGROUND: Successful treatment of anaphylaxis in the community relies on early and correct use of epinephrine auto-injectors (EAI). In the Netherlands pharmacists supply EAIs to patients and have a crucial role in instructing patients in how and when to use EAI. However, there are currently no data in Europe on the quality of such instruction provided by pharmacists. Therefore, the aims of this study were to investigate the knowledge, attitudes, and beliefs regarding food allergy among pharmacists in the Netherlands, and to investigate the quality of EAI instructions and demonstrations to patients by pharmacists...
December 19, 2016: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/27984266/unintentional-epinephrine-auto-injector-injuries-a-national-poison-center-observational-study
#14
Marco Anshien, S Rutherfoord Rose, Brandon K Wills
BACKGROUND: Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. STUDY QUESTION: The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures...
November 24, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27979023/rate-of-recurrent-anaphylaxis-and-associated-risk-factors-among-olmsted-county-minnesota-residents-a-population-based-study
#15
Sangil Lee, Curtis Bashore, Christine M Lohse, M Fernanda Bellolio, Alanna Chamberlain, Kumi Yuki, Erik P Hess, Ronna L Campbell
BACKGROUND: The rate and risk factors for recurrence of anaphylaxis are not well known. OBJECTIVE: To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. METHODS: We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27957774/pediatric-anaphylaxis-in-the-operating-room-for-anesthesia-residents-a-simulation-study
#16
Emily B Johnston, Collin King, Peter A Sloane, Jerral W Cox, Amber Q Youngblood, Jerry Lynn Zinkan, Nancy M Tofil
BACKGROUND: Pediatric intraoperative emergencies are rare but it is crucial for an anesthesia resident to be proficient in their management. Even the more common emergencies like anaphylaxis may not happen frequently for this proficiency to occur. Simulation increases exposure to these rare events in a safe learning environment to improve skills and build confidence while standardizing curriculum. OBJECTIVE: Anesthesia residents participated in a simulated case of intraoperative pediatric anaphylaxis to evaluate knowledge and performance gaps...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27939824/pulmonary-platelet-accumulation-induced-by-catecholamines-its-involvement-in-lipopolysaccharide-induced-anaphylaxis-like-shock
#17
Zhiqian Yu, Hiroko Saito, Hirotada Otsuka, Yosuke Shikama, Hiromi Funayama, Mai Sakai, Shigeo Murai, Masanori Nakamura, Takashi Yokochi, Haruhiko Takada, Shunji Sugawara, Yasuo Endo
Intravenously injected lipopolysaccharides (LPS) rapidly induce pulmonary platelet accumulation (PPA) and anaphylaxis-like shock (ALS) in mice. Macrophages reportedly release catecholamines rapidly upon stimulation with LPS. Here, we examined the involvement of macrophage-derived catecholamines in LPS-induced PPA and ALS. A catecholamine or Klebsiella O3 (KO3) LPS was intravenously injected into mice, with 5-hydroxytryptamine in the lung being measured as a platelet marker. The tested catecholamines induced PPA, leading to shock...
February 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/27923649/food-allergy-trends-and-epinephrine-autoinjector-presence-in-summer-camps
#18
Natalie R Schellpfeffer, Harvey L Leo, Michael Ambrose, Andrew N Hashikawa
BACKGROUND: Pediatric campers with food allergies are at greater risk for exposure and anaphylaxis. A diagnosis of asthma increases risk for anaphylaxis. Epidemiological investigations of food-allergic children at high risk for allergic reactions requiring intervention in camp settings are lacking. OBJECTIVE: The objectives of this study were to estimate the prevalence of food allergies among otherwise healthy campers in summer camps throughout the United States and Canada, and to assess asthma comorbidity and determine rates of epinephrine autoinjector prescriptions present in this population...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27922561/a-pharmacologic-review-of-anaphylaxis
#19
Nancy S Yunker, Bradley J Wagner
Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning...
October 2016: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/27892597/a-multicenter-study-on-anaphylaxis-caused-by-peanut-tree-nuts-and-seeds-in-children-and-adolescents
#20
K Jeong, S-Y Lee, K Ahn, J Kim, H-R Lee, D I Suh, B-Y Pyun, T K Min, J-W Kwon, K-E Kim, K W Kim, M H Sohn, Y H Kim, T W Song, J H Kwon, Y H Jeon, H Y Kim, J H Kim, Y M Ahn, S Lee
Peanut (PN) and tree nuts (TNs) are common causes of anaphylaxis in Western countries, but no information is available in Korea. To feature clinical characteristics of anaphylaxis caused by PN, TNs, and seeds, a retrospective medical record review was performed in 14 university hospitals in Korea (2009-2013). One hundred and twenty-six cases were identified, with the mean age of 4.9 years. PN, walnut (WN), and pine nut accounted for 32.5%, 41.3%, and 7.1%, respectively. The median values of specific IgE (sIgE) to PN, WN, and pine nut were 10...
November 28, 2016: Allergy
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