Epinephrine Autoinjector T300 26-27

Epinephrine Autoinjector

Adrenaclick, Auvi-Q, EpiPen, EpiPen Jr.

Epinephrine Autoinjector Drug Class

Alpha/Beta Agonist, Anaphylaxis Agent

Epinephrine Autoinjector Dosage Forms

Solution for Autoinjection: 0.1 mg/0.1 mL, 0.15 mg/0.15 mL, 0.15 mg/0.3 mL, 0.3 mg/0.3 mL

Epinephrine Autoinjector Dosing By Indication

1. Emergency treatment of acute anaphylaxis due to allergic reactions: Using autoinjector, Children 7.5-14 kg, 0.1 mg IM or SUBQ; Children 15-29 kg, 0.15 mg IM or SUBQ; Children ≥30 kg and Adults, 0.3 mg IM or SUBQ; may be repeated if severe anaphylaxis persists

Epinephrine Autoinjector Off Label Uses

None

Epinephrine Autoinjector MOA

Stimulates α- and β-adrenergic receptors. Alpha agonism results in vascular smooth muscle constriction which increases BP. Beta-1 agonism will increase HR and contractility. Beta-2 agonism results in bronchial smooth muscle relaxation thus alleviating bronchospasm, wheezing, and dyspnea. This drug treats severe allergic reactions to insect stings or bites, foods, drugs, and other allergens. It also alleviates pruritus, urticaria, and angioedema.

Epinephrine Autoinjector Common Adverse Effects

Anxiety, apprehension, headache, nausea, palpitations, pale complexion, restlessness, sweating, tremor, nausea

Epinephrine Autoinjector Efficacy Monitoring Parameters

Resolution of symptoms of anaphylaxis (dyspnea, pruritus, urticaria, angioedema).

Epinephrine Autoinjector Safety Monitoring Parameters

Seek medical attention after emergency use and monitor for signs of cardiac toxicity and HTN.

Epinephrine Autoinjector Key Counseling Points

Instruct patient on proper administration technique. Immediately seek medical assistance, even if the patient feels better after epinephrine use. Inject into the anterolateral aspect of thigh, and not into buttock, digits, hands, or feet. Leg should be held firmly during injection. The injection should only be held in thigh for 2-10 s (varies with manufacturer); injury can result if left in leg for longer time. Autoinjector for IM or SUBQ administration—should not be used IV.

Epinephrine Autoinjector Clinical Pearls

Epinephrine autoinjectors are intended for immediate self-administration as emergency supportive therapy only and are not a substitute for immediate medical care. Also available as an intranasal formulation. When treating anaphylaxis, IV route should not be used as arrhythmias may occur. A number of other injectable formulations of epinephrine are available for use in a wide variety of applications in the acute care setting, including in cardiac resuscitation attempts and in combination with topical anesthetic as a vasodilator to reduce bleeding during suturing and other minor surgical procedures. Ophthalmic and inhaled dosage forms are also available for other indications. Historic expression of concentration as a ratio of mass of epinephrine per unit of volume (eg, 1:1000 representing 1 g epinephrine per 1000 mL solution) are now prohibited on labels due to safety risks; instead, standard concentration expressions should be used (eg, 1:1000 should be represented as 1 mg/mL and 1:10,000 should be represented as 0.1 mg/mL)