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Owen Dyer
No abstract text is available yet for this article.
August 21, 2017: BMJ: British Medical Journal
Herman Tam, F Estelle R Simons, Elinor Simons
No abstract text is available yet for this article.
August 2017: Annals of Allergy, Asthma & Immunology
Marcus Shaker, Katherine Bean, Marylee Verdi
BACKGROUND: Three commercial epinephrine auto-injectors were available in the United States in the summer of 2016: EpiPen, Adrenaclick, and epinephrine injection, USP auto-injector. OBJECTIVE: To describe the variation in pharmacy costs among epinephrine auto-injector devices in New England and evaluate the additional expense associated with incremental auto-injector costs. METHODS: Decision analysis software was used to evaluate costs of the most and least expensive epinephrine auto-injector devices for children with peanut allergy...
August 2017: Annals of Allergy, Asthma & Immunology
F Lee Cantrell, Patricia Cantrell, Anita Wen, Roy Gerona
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
Myto Duong, Albert Botchway, Jonathan Dela Cruz, Richard Austin, Kevin McDaniel, Cassie Jaeger
INTRODUCTION: Pediatric obesity threatens the efficacy of medications given intramuscularly. In anaphylactic patients, epinephrine auto-injector needle lengths are potentially too short to reach the muscle compartment in patients with elevated body habitus. The objective of the study was to determine needle-length requirements for intramuscular injections in pediatric patients. METHODS: We used ultrasound to measure the distance from skin to muscle compartment of the thigh in 200 pediatric patients of various weight and body mass index who presented to the emergency department...
April 2017: Western Journal of Emergency Medicine
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...
May 2017: Journal of Allergy and Clinical Immunology in Practice
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
Jeff Lyon
No abstract text is available yet for this article.
October 11, 2016: JAMA: the Journal of the American Medical Association
Rita Rubin
No abstract text is available yet for this article.
September 24, 2016: Lancet
Robert L Hill, John G Wilmot, Beth A Belluscio, Kevin Cleary, David Lindisch, Robin Tucker, Emmanuel Wilson, Rajesh B Shukla
Parenteral routes of drug administration are often selected to optimize actual dose of drug delivered, assure high bioavailability, bypass first-pass metabolism or harsh gastrointestinal environments, as well as maximize the speed of onset. Intramuscular (IM) delivery can be preferred to intravenous delivery when initiating intravenous access is difficult or impossible. Drugs can be injected intramuscularly using a syringe or an automated delivery device (autoinjector). Investigation into the IM delivery dynamics of these methods may guide further improvements in the performance of injection technologies...
2016: Medical Devices: Evidence and Research
Susan L Hogue, Diana Goss, Kelly Hollis, Suyapa Silvia, Martha V White
BACKGROUND: Anaphylaxis is a serious, potentially life-threatening condition. Adequate preparation for anaphylaxis management is imperative for school personnel. This descriptive pilot study assessed preparedness of US schools to manage anaphylactic reactions. METHODS: An exploratory, cross-sectional, web-based, pilot survey assessed the occurrence and characteristics of anaphylactic events, as well as training provided to school personnel for the recognition and treatment of anaphylaxis...
2016: Journal of Asthma and Allergy
Adam Rubenfire
No abstract text is available yet for this article.
April 4, 2016: Modern Healthcare
Sten Dreborg, Xia Wen, Laura Kim, Gina Tsai, Immaculate Nevis, Ryan Potts, Jack Chiu, Arunmozhi Dominic, Harold Kim
BACKGROUND: Food allergy is the most common cause of anaphylaxis in children. Intramuscular delivery of epinephrine auto-injectors (EAI) is the standard of care for the treatment of anaphylaxis. We examined if children and adolescents at risk of anaphylaxis weighing 15-30 kg and >30 kg would receive epinephrine into the intramuscular space with the currently available EAI in North America and Europe. METHODS: The distance from skin to muscle (STMD) and skin to bone (STBD) on the mid third anterolateral area of the right thigh was measured by ultrasound applying either high pressure (max) or slight pressure (min) in 102 children weighing 15-30 kg (group 1) and 100 children and adolescents, weighing more than 30 kg (group 2)...
2016: Allergy, Asthma, and Clinical Immunology
Julie C Brown, Rachel E Tuuri
No abstract text is available yet for this article.
May 2016: Journal of Allergy and Clinical Immunology in Practice
Noriyuki Yanagida, Katsuhito Iikura, Kiyotake Ogura, Ling-jen Wang, Tomoyuki Asaumi, Sakura Sato, Motohiro Ebisawa
PURPOSE: Reports on accidental auto-injection of adrenaline are few. We encountered three cases of accidental injection of adrenaline. In this study, we have examined and reported the clinical courses and symptoms of our cases. CASE: CASE 1 involved a female physician in her 50s who had attended an explanatory meeting on auto-injection of adrenaline. She mistook EpiPen® to be the EpiPen trainer and accidentally injected herself with 0.3 mg EpiPen®. Her systolic/diastolic pressure peaked at 7 min to reach 144/78 mmHg and decreased to 120/77 mmHg at 14 min...
December 2015: Arerugī, [Allergy]
Stacy Sellek
No abstract text is available yet for this article.
January 2014: Michigan Medicine
T Umasunthar, A Procktor, M Hodes, J G Smith, C Gore, H E Cox, T Marrs, H Hanna, K Phillips, C Pinto, P J Turner, J O Warner, R J Boyle
BACKGROUND: Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices. METHODS: We allocated mothers of food-allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer-generated randomization list, with optimal training according to manufacturer's instructions...
July 2015: Allergy
Sandra M Salter, Richard Loh, Frank M Sanfilippo, Rhonda M Clifford
BACKGROUND: Successful treatment of anaphylaxis in the community relies on early and correct use of epinephrine autoinjectors. Community pharmacists supply these devices and have a crucial role teaching patients how to use them. Supply of epinephrine autoinjectors in Australia increased 70-fold in the past decade. New EpiPen and Anapen autoinjectors were launched in Australia in 2011 and 2012, with the potential to cause confusion. However there is no information about how pharmacists demonstrate epinephrine autoinjectors to patients...
2014: Allergy, Asthma, and Clinical Immunology
Laura Kim, Immaculate Fp Nevis, Gina Tsai, Arunmozhi Dominic, Ryan Potts, Jack Chiu, Harold L Kim
BACKGROUND: The Epipen® Jr and Allerject® 0.15 mg are currently the most commonly prescribed epinephrine auto-injectors (EAIs) for the management of anaphylaxis in pediatric patients in North America and Canada. To ensure rapid absorption, it should be administered intramuscularly into the anterolateral aspect of the thigh. We examined whether the 12.7-mm needle length of the Epipen® Jr and Allerject® 0.15 mg is adequate for delivering epinephrine intramuscularly in pediatric patients who weighed <15 kg...
2014: Allergy, Asthma, and Clinical Immunology
Gina Tsai, Laura Kim, Immaculate Fp Nevis, Arunmozhi Dominic, Ryan Potts, Jack Chiu, Harold L Kim
BACKGROUND: Epinephrine auto-injectors are the standard first aid treatment for anaphylaxis. Intramuscular delivery into the anterolateral aspect of the thigh is recommended for optimal onset of action of epinephrine. The most frequently prescribed auto-injector in North America and Canada is the EpiPen(®), which has a needle length of 15.2 mm. Currently, it is unknown whether this needle length is adequate for intramuscular delivery of epinephrine in adult patients at risk of anaphylaxis...
2014: Allergy, Asthma, and Clinical Immunology
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