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A 0.3 mg EpiPen auto-injector.

An epinephrine autoinjector is a medical device used to deliver a measured dose (or doses) of epinephrine (commonly known as adrenalin) using autoinjector technology, most frequently for the treatment of acute allergic reactions to avoid or treat the onset of anaphylactic shock. Trade names for this device include EpiPen, Anapen and Twinject.

Contents

Description

The devices contain a spring-loaded needle that exits the tip of the device (in some cases through a sterile membrane) and into the recipient's body to deliver the medication.

Epinephrine autoinjectors contain a pre-determined dose of epinephrine, usually between 0.3 mg[1][2] and 0.5 mg[1][3] of active ingredient at a concentration of 1:1000. Manufacturers have also made paediatric dosed versions available at 0.15 mg of active ingredient,[1][4] and there is also a version which contains two individual doses, in case a repeated application is required, sold under the trade name Twinject.[5]

In most countries, epinephrine is a prescription drug, and therefore obtaining the device requires a prescription from a doctor. However, in some jurisdictions, for instance Canada, epinephrine autoinjectors are an over-the-counter drug and may be purchased from a pharmacy counter.

Usage

After activation the patient holds the device in place for 10 seconds as the epinephrine is delivered. This gives the drug enough time to be absorbed by the body's muscles and diffused into the bloodstream. Using the device intravenously is highly discouraged, and can even be lethal as epinephrine is a local vascular constrictor, and use intravenously can restrict blood flow to the area of the injection site, causing subsequent damage to extremities. Additionally, intravenous administration of the epinephrine can cause ventricular tachycardia, or dangerously rapid heartbeat.[6] After administering the device, patients are advised to seek immediate medical attention.

1998 Recall

On May 8 1998, a voluntary Class I recall took place in a number of countries (the United States, Germany, Israel, Denmark, Canada, Turkey, Australia, Greece and South Africa). Epipen (0.3 mg) and Epipen Jr. (0.15 mg) epinephrine auto-injectors were recalled because certain devices originating from specific production lots were found to be ineffective in delivering medication and treating anaphylaxis.[7] This issue was resolved within the same year.

Long-term effectiveness

None of these devices prevents future episodes of anaphylaxis, but patients who experience severe or life-threatening reactions may be treated with a series of allergy injections composed of increasing concentrations of naturally occurring substances such as venom to provide excellent and usually life-long protections against adverse effects of future insect stings: these injections are astonishingly dilute—a billion-fold or more is common.[8]

Origin

The EpiPen was originally derived from the ComboPen, a product developed for the military for treatment for exposure to nerve agents. The inventor of the ComboPen and the EpiPen was Sheldon Kaplan, who died in September 2009.[9]

See also

References

External links


EpiPen is a registered trademark for a commonly used autoinjector of epinephrine (a.k.a. adrenaline), used in medicine to treat anaphylactic shock.

Contents

Description

EpiPen is manufactured by DEY L.P. EpiPens are commonly carried by persons with severe allergies and a risk of anaphylactic shock because they can be self-administered and are very fast-acting. In the UK and US, EpiPens are regulated medical devices and require a medical prescription. In Canada, EpiPens may be purchased without a prescription, but they are kept behind pharmacy counters.

The standard dosage of epinephrine supplied by an EpiPen is 0.3 ml of 1 in 1000 Parts (0.3 mg). Child-sized dosages (0.15 mg) are available as the EpiPen JR. In the US, EpiPen JR is recommended for children 33-66 lb.[1], while in Canada it is recommended for children 15 to 30 kg. [2]

The EpiPen contains a spring-loaded needle that shoots through a membrane in the tip and into the recipient's body to deliver the medication.

EpiPen usually has a shelf life of 20 months. If unused, the EpiPen should be discarded by returning it to a local pharmacy or hospital for safe disposal.

The original carrying tube that the pen came in was easily broken; however, the manufacturer now ships EpiPens in more durable carrying tubes with significantly thicker plastic walls, a screw top, and metal plating at the bottom (needle) end to prevent puncture injuries.

Despite being trademarked, common usage of the word "epipen" is drifting toward the generic context of any epinephrine autoinjector.[citation needed]

Instructions

Directions for use of the injector are found on the device itself. EpiPens manufactured before December 2004 carried instructions for use stating that after the locking cap was removed, the device was put to the injection site and then pressure was applied to activate the mechanism.

All EpiPens manufactured since December 2004 carry a new version of the instructions, which are assumed to be more intuitive.[3] In the new instructions, approved by the Government’s Medicines and Healthcare products Regulatory Agency (UK), a patient uses the device by removing the gray locking cap from the top of the device, forming a fist around the unit, and jabbing it firmly into a thigh until the click of the spring-loaded needle activating is heard. Both sets of instructions are valid.

Regardless of the instruction version, after activation the patient holds the device in place for 10 seconds as the epinephrine is delivered. This gives the drug enough time to be absorbed by the body's muscles and diffused into the bloodstream. Using the device intravenously is highly discouraged, and can even be lethal as epinephrine is a local vascular constrictor, and use intravenously can restrict blood flow to the area of the injection site, causing subsequent damage to extremities. Additionally, intravenous administration of the EpiPen can cause ventricular tachycardia, or dangerously rapid heartbeat. [4] After administering the device, patients are advised to seek immediate medical attention.

1998 Recall

On May 8 1998, a voluntary Class I recall took place in a number of countries (the United States, Germany, Israel, Denmark, Canada, Turkey, Australia, Greece and South Africa). Epipen (0.3 mg) and Epipen Jr. (0.15 mg) epinephrine auto-injectors were recalled because certain devices originating from specific production lots were found to be ineffective in delivering medication and treating anaphylaxis. [1] This issue was resolved within the same year.

Alternatives

Companies other than Dey have begun to market similar devices, such as Twinject, the only epinephrine auto-injector in North America to include two doses in each device. Ampules of epinephrine are also available for single use in physician offices and hospital pharmacies, as are preloaded Tubex cartridges. None of these devices prevents future episodes of anaphylaxis, but patients who experience severe or life-threatening reactions may be treated with a series of allergy injections composed of increasing concentrations of naturally occurring substances such as venom to provide excellent and usually life-long protections against adverse effects of future insect stings: these injections are astonishingly dilute—a billion-fold or more is common. [2]

See also

References

  1. ^ http://www.fda.gov/MEDWATCH/safety/1998/epipen.htm
  2. ^ Resiman, R (August 1994). "Insect Stings". New England Journal of Medicine 26: 523–7. doi:10.1056/NEJM199408253310808. PMID 8041420. 

External links


Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

English

Proper noun

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Wikipedia

EpiPen

  1. (trademark) a device for the autoinjection of adrenaline; used by people who suffer from severe allergies and risk anaphylactic shock







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