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Epinephrine Autoinjector

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1. Epinephrine autoinjectors available in Canada

Epinephrine autoinjectors available in Canada Epinephrine autoinjectors available in Canada April - May 2019 Mailing Address: Therapeutics Initiative The University of British Columbia Department of Anesthesiology, Pharmacology & Therapeutics 2176 Health Sciences Mall Vancouver, BC Canada V6T 1Z3 Tel.: 604 822 0700 Fax: 604 822 0701 E-mail: info@ti.ubc.ca www.ti.ubc.ca 119 A naphylaxis is one of the most dramatic health crises. Experiencing or witnessing this acute and serious allergy event (...) mucosal edema and induces bronchodilation. 5,6 What evidence underlies the use of epinephrine autoinjectors? Epinephrine was first marketed almost 120 years ago, yet many practical issues are not firmly answered. Should epinephrine be admin - istered at the earliest onset of mild symptoms or reserved for severe symptoms? What is the opti- mal dose? A Cochrane 2008 systematic review identified ethical and practical issues associat - ed with performing randomized, double-blind, placebo-controlled trials

2019 Therapeutics Letter

2. Who needs to carry an epinephrine autoinjector? (PubMed)

Who needs to carry an epinephrine autoinjector? Patients who have had anaphylaxis or who are at risk of it (eg, due to food allergy or Hymenoptera hypersensitivity) should carry an epinephrine autoinjector at all times. However, the risks and benefits must be considered on an individual basis, especially in patients with atherosclerotic heart disease, elderly patients on polypharmacy, patients receiving allergen immunotherapy, those with large local reactions to insect stings, and individuals

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2019 Cleveland Clinic Journal of Medicine

3. The cost-effectiveness of requiring universal vs contextual self-injectable epinephrine autoinjector for allergen immunotherapy. (PubMed)

The cost-effectiveness of requiring universal vs contextual self-injectable epinephrine autoinjector for allergen immunotherapy. Aeroallergen immunotherapy (AIT) is a safe and effective disease-modifying treatment associated with rare therapy-associated fatality. Significant practice variation surrounds universal or contextual prescription of self-injectable epinephrine (SIE) for patients receiving AIT.To characterize the cost-effectiveness of a universal vs contextual SIE requirement (...) prescription could be cost-effective if it provided a 1000 times protection against AIT fatality at a value-based cost of $24, and the annual AIT fatality rates unrealistically exceed 2.6 per 10,000 patients.In a simulation of potential SIE-prescribing strategies for patients receiving AIT, a universal approach to an epinephrine autoinjector requirement was not cost-effective when compared with an approach in which an SIE is prescribed only to patients with prior SRIT.Copyright © 2019 American College

2019 Asthma & Immunology

4. JOURNAL CLUB: Benefit of Epinephrine Autoinjector for Treatment of Contrast Reactions: Comparison of Errors, Administration Times, and Provider Preferences. (PubMed)

JOURNAL CLUB: Benefit of Epinephrine Autoinjector for Treatment of Contrast Reactions: Comparison of Errors, Administration Times, and Provider Preferences. Given the rarity of contrast reactions in practice, most radiologists have little to no experience in their management, and errors are common. The purpose of this study was to compare treatment of a moderate-severity reaction with intramuscular epinephrine by either the traditional manual method of drawing up and delivering epinephrine (...) with a needle and syringe or the use of an epinephrine autoinjector.All diagnostic radiologists at the study institution were requested to participate in an annual contrast reaction simulation program, which consisted of three simulation scenarios in a high-fidelity simulation laboratory. During the moderate-severity simulation scenario, the time to administer intramuscular epinephrine and any errors in administration were recorded. Groups were randomized to use an autoinjector device or manual delivery

2017 AJR. American journal of roentgenology

5. Contemporary issues in anaphylaxis and the evolution of epinephrine autoinjectors: What will the future bring? (PubMed)

Contemporary issues in anaphylaxis and the evolution of epinephrine autoinjectors: What will the future bring? Food allergy and anaphylaxis appear to be increasing in the United States, especially in young children, and preparedness is paramount to successful emergency management in the community. Although the treatment of choice for anaphylaxis is epinephrine delivered by autoinjection, some devices are challenged by less user-friendly designs or pose the risk of injury, especially in young (...) patients. Human factors engineering has played a larger role in the development of more recent epinephrine autoinjector technologies and will continue to play a role in the evolution and future design of epinephrine autoinjectors.To discuss contemporary issues related to the identification and management of anaphylaxis, current and future epinephrine autoinjector design, and unmet needs for the treatment of special populations, namely, young children weighing less than 15 kg.The literature was reviewed

2017 Asthma & Immunology

6. Guidance for compassionate restraint of small children to prevent injuries with epinephrine autoinjectors. (PubMed)

Guidance for compassionate restraint of small children to prevent injuries with epinephrine autoinjectors. Without securing a child properly, injuries can happen with the use of pediatric epinephrine autoinjectors (EAI), and lacerations and embedded needles have been reported. Health care providers should ensure that instruction is provided to parents on how to hold a child during an injection with an EAI.To demonstrate the compassionate restraint of small children during an allergic emergency

2017 Allergy and Asthma Proceedings

7. Inadequacy of current pediatric epinephrine autoinjector needle length for use in infants and toddlers. (PubMed)

Inadequacy of current pediatric epinephrine autoinjector needle length for use in infants and toddlers. Epinephrine injection represents the standard of care for anaphylaxis treatment. It is most effective if delivered intramuscularly, whereas inadvertent intraosseous injection may be harmful. The needle length in current pediatric epinephrine autoinjectors (EAIs) is 12.7 mm; however, the ideal needle length for infants and toddlers weighing less than 15 kg is unknown.To determine the skin

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2017 Asthma & Immunology

8. EPINEPHrine for Anaphylaxis: Autoinjector or 1-mg Vial or Ampoule? (PubMed)

EPINEPHrine for Anaphylaxis: Autoinjector or 1-mg Vial or Ampoule? Epinephrine for anaphylaxis: Autoinjector or 1-mg vial or ampoule?

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2017 Pharmacy and Therapeutics

9. Medicaid Expenditures and Estimated Rebates for Epinephrine Autoinjectors, 2012 to 2016 (PubMed)

Medicaid Expenditures and Estimated Rebates for Epinephrine Autoinjectors, 2012 to 2016 28346577 2019 01 18 2019 01 18 2168-6114 177 5 2017 05 01 JAMA internal medicine JAMA Intern Med Medicaid Expenditures and Estimated Rebates for Epinephrine Autoinjectors, 2012 to 2016. 734-736 10.1001/jamainternmed.2017.0257 Luo Jing J Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital (...) , Massachusetts. eng Journal Article United States JAMA Intern Med 101589534 2168-6106 YKH834O4BH Epinephrine AIM IM Centers for Medicare and Medicaid Services (U.S.) Cost of Illness Epinephrine administration & dosage economics Health Expenditures statistics & numerical data Humans Injections, Intramuscular economics instrumentation Insurance, Health, Reimbursement economics statistics & numerical data Managed Care Programs economics Medicaid economics statistics & numerical data United States 2017 3 28 6 0

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2017 JAMA Internal Medicine

10. Out-of-Pocket Spending Among Commercially Insured Patients for Epinephrine Autoinjectors Between 2007 and 2014 (PubMed)

Out-of-Pocket Spending Among Commercially Insured Patients for Epinephrine Autoinjectors Between 2007 and 2014 28346591 2019 01 18 2019 01 18 2168-6114 177 5 2017 05 01 JAMA internal medicine JAMA Intern Med Out-of-Pocket Spending Among Commercially Insured Patients for Epinephrine Autoinjectors Between 2007 and 2014. 736-739 10.1001/jamainternmed.2017.0252 Chua Kao-Ping KP Section of Academic Pediatrics, Department of Pediatrics, University of Chicago, Chicago, Illinois2Department of Public (...) Health Sciences, University of Chicago, Chicago, Illinois. Conti Rena M RM Department of Public Health Sciences, University of Chicago, Chicago, Illinois3Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of Chicago, Chicago, Illinois. eng Journal Article Research Support, Non-U.S. Gov't United States JAMA Intern Med 101589534 2168-6106 YKH834O4BH Epinephrine AIM IM Anaphylaxis economics Cost Savings statistics & numerical data Cost of Illness Epinephrine administration

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2017 JAMA Internal Medicine

11. Accidental Thumb Injection With an Epinephrine Autoinjector (PubMed)

Accidental Thumb Injection With an Epinephrine Autoinjector 29229045 2018 12 11 2018 12 11 1866-0452 114 47 2017 Nov 24 Deutsches Arzteblatt international Dtsch Arztebl Int Accidental Thumb Injection With an Epinephrine Autoinjector. 804 10.3238/arztebl.2017.0804 arztebl.2017.0804 Fritz Tobias T Pohlemann Tim T Klein Moritz M eng Case Reports Journal Article Germany Dtsch Arztebl Int 101475967 1866-0452 0 Adrenergic alpha-Agonists YKH834O4BH Epinephrine IM Adrenergic alpha-Agonists (...) administration & dosage adverse effects Epinephrine administration & dosage adverse effects Female Humans Injections, Subcutaneous Middle Aged Thumb pathology 2017 12 13 6 0 2017 12 13 6 0 2018 12 12 6 0 ppublish 29229045 arztebl.2017.0804 10.3238/arztebl.2017.0804 PMC5736864

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2017 Deutsches Ärzteblatt international

12. Adherence with epinephrine autoinjector prescriptions in primary care (PubMed)

Adherence with epinephrine autoinjector prescriptions in primary care The aim of this study was to estimate primary adherence for epinephrine autoinjector (EA) prescriptions in primary care practices in Manitoba, Canada.A retrospective analysis of electronic medical record and administrative data was performed to determine primary adherence, defined as dispensation of a new EA prescription within 90 days of the date the prescription was written. Multivariable logistic regression models were

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2017 Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

13. Epinephrine Autoinjector Prescribing Patterns in an Urban Pediatric Population (PubMed)

Epinephrine Autoinjector Prescribing Patterns in an Urban Pediatric Population 27130713 2018 11 06 2018 11 13 2213-2201 4 5 2016 Sep-Oct The journal of allergy and clinical immunology. In practice J Allergy Clin Immunol Pract Epinephrine autoinjector prescribing patterns in an urban pediatric population. 989-90 10.1016/j.jaip.2016.03.018 S2213-2198(16)30056-3 Sann Julia J Division of Allergy & Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY (...) Clin Immunol Pract 101597220 YKH834O4BH Epinephrine IM Adolescent Allergy and Immunology statistics & numerical data Anaphylaxis drug therapy Child Child, Preschool Drug Prescriptions statistics & numerical data Epinephrine administration & dosage Female Humans Infant Injections Male Referral and Consultation statistics & numerical data Retrospective Studies Self Administration Young Adult The authors declare they have no relevant conflicts of interest. 2016 02 11 2016 03 18 2016 03 29 2016 5 1 6 0

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2016 The journal of allergy and clinical immunology. In practice

14. Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions (PubMed)

Autoinjectors Preferred for Intramuscular Epinephrine in Anaphylaxis and Allergic Reactions Epinephrine is the treatment of choice for anaphylaxis. We surveyed emergency department (ED) healthcare providers regarding two methods of intramuscular (IM) epinephrine administration (autoinjector and manual injection) for the management of anaphylaxis and allergic reactions and identified provider perceptions and preferred method of medication delivery.This observational study adhered to survey (...) reporting guidelines. It was performed through a Web-based survey completed by healthcare providers at an academic ED. The primary outcomes were assessment of provider perceptions and identification of the preferred IM epinephrine administration method by ED healthcare providers.Of 217 ED healthcare providers invited to participate, 172 (79%) completed the survey. Overall, 82% of respondents preferred the autoinjector method of epinephrine administration. Providers rated the autoinjector method more

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2016 Western Journal of Emergency Medicine

15. Epinephrine Autoinjector

Epinephrine Autoinjector Epinephrine Autoinjector Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Epinephrine Autoinjector Epinephrine (...) Autoinjector Aka: Epinephrine Autoinjector , Epinephrine Home Injectable Devices , EpiPen , EpiPen Jr , Twinject , Adrenaclick , Ana-Guard , Ana-kit , Auvi-Q From Related Chapters II. Indications Indicated for history severe reaction or Patient injects at time of III. Precautions Immediate medical attention after using injector Further management may be required Replace the autoinjector before it expires (avoid relying on an expired injector) May try the expired injector if no alternative Keep the away

2018 FP Notebook

16. EPINEPHRINE AUTOINJECTOR PRESCRIBING TRENDS: AN OUTPATIENT POPULATION-BASED STUDY IN OLMSTED COUNTY, MINNESOTA (PubMed)

EPINEPHRINE AUTOINJECTOR PRESCRIBING TRENDS: AN OUTPATIENT POPULATION-BASED STUDY IN OLMSTED COUNTY, MINNESOTA The prescribing pattern of epinephrine over time is an indicator of the secular trend of anaphylaxis. However, it is not well known in a population level in the United States.To evaluate the trend of prescriptions for epinephrine autoinjectors in Olmsted County, Minn, residents.Outpatient prescriptions for epinephrine were identified among residents of Olmsted County, Minn, between (...) Poisson regression models using the SAS procedure GENMOD.The overall incidence rate of epinephrine autoinjector prescriptions during the study period was 757 per 100,000 person-years (95% confidence interval: 740-774). The prescription rates per patient per year increased over time, with an annual rate of increase of 8% (P < .001), but the rates per patient remained stable (P = .077). For each year, incidence rates overall were higher in women compared with men (P < .001). From ages 0 to 19, incidence

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2016 The journal of allergy and clinical immunology. In practice

17. Randomized comparison of caregivers' ability to use epinephrine autoinjectors and prefilled syringes for anaphylaxis. (PubMed)

Randomized comparison of caregivers' ability to use epinephrine autoinjectors and prefilled syringes for anaphylaxis. Caregivers often incorrectly use epinephrine autoinjectors. It is unclear whether this is due to insufficient training or a difficult-to-use tool. Furthermore, the high costs of epinephrine autoinjectors may limit their availability; so low-cost prefilled syringes may be the alternative.We performed a prospective randomized trial to compare successful epinephrine administration (...) at four stages: after reading written instructions, and immediately after, 6 weeks, and 3 months following video training. The time required for successful epinephrine administration and failed steps in the administration of epinephrine autoinjectors and prefilled syringe were also investigated.Complete data analysis of 113 participants (prefilled syringe group, n=57; EpiPen, n=56) was performed. Significantly more participants correctly demonstrated the use of prefilled syringes compared to EpiPen

2018 Asian Pacific journal of allergy and immunology

18. Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children. (PubMed)

Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children. Epinephrine autoinjector use for anaphylaxis is increasing. There are reports of digit injections because of incorrect autoinjector use, but no previous reports of lacerations, to our knowledge. We report complications of epinephrine autoinjector use in children and discuss features of these devices, and their instructions for use, and how these may contribute to injuries.We queried emergency medicine e-mail (...) discussion lists and social media allergy groups to identify epinephrine autoinjector injuries involving children.Twenty-two cases of epinephrine autoinjector-related injuries are described. Twenty-one occurred during intentional use for the child's allergic reaction. Seventeen children experienced lacerations. In 4 cases, the needle stuck in the child's limb. In 1 case, the device lacerated a nurse's finger. The device associated with the injury was operated by health care providers (6 cases

2015 Annals of Emergency Medicine

19. Do parents of children with allergic reactions know how to use adrenaline autoinjectors appropriately?

of EpiPen for children with food allergies. J Allergy Clin Immunol 2005;116(1):164-8 Blyth TP, Sundrum R. Adrenaline autoinjectors and schoolchildren: a community based study. Archives of Disease in Childhood 2002;86(1):26-7. Gold MS, Sainsbury R. First aid anaphylaxis management in children who were prescribed an epinephrine autoinjector device (EpiPen). J Allergy Clin Immunol 2000;106(1 Pt 1):171-6. Sicherer SH, Forman JA, Noone SA. Use Assessment of Self-Administered Epinephrine Among Food-Allergic (...) Do parents of children with allergic reactions know how to use adrenaline autoinjectors appropriately? BestBets: Do parents of children with allergic reactions know how to use adrenaline autoinjectors appropriately? Do parents of children with allergic reactions know how to use adrenaline autoinjectors appropriately? Report By: Jennifer Lewis - 4th Year Medical Student Search checked by David Drake - Specialist Trainee in Emergency Medicine Institution: Manchester Royal Infirmary, Manchester

2014 BestBETS

20. Do Doctors know how to use adrenaline autoinjectors correctly?

and Pediatricians. Pediatrics 2000;105:359–62. Jarvinen KM, Sicherer SH, Sampson HA, et al. Use of multiple doses of epinephrine in food-induced anaphylaxis in children. J Allergy Clin Immunol 2008;122:133–8. Mehr S, Robinson M, Tang M. Doctor--how do I use my EpiPen? Pediatr Allergy Immunol 2007;18:448–52. Arga M, Bakirtas A, Catal F, et al. Training of trainers on epinephrine autoinjector use. Pediatr Allergy Immunol 2011;22:590–3. Grouhi M, Alshehri M, Hummel D, et al. Anaphylaxis and epinephrine auto (...) Do Doctors know how to use adrenaline autoinjectors correctly? BestBets: Do Doctors know how to use adrenaline autoinjectors correctly? Do Doctors know how to use adrenaline autoinjectors correctly? Report By: Jennifer Lewis - 4th Year Medical Student Search checked by David Drake - David Drake, Specialist Trainee in Emergency Medicine Institution: Manchester Royal Infirmary Manchester, UK Date Submitted: 13th July 2013 Date Completed: 24th February 2014 Last Modified: 26th February 2014 Status

2014 BestBETS

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