Ram FSF (2011).
Self-Injectable Adrenaline for Anaphylactic Emergencies: Effectiveness of Epipen and Anapen – Are they Fit for Purpose – Evidence to Date.
J Aller Ther 3:116. doi:10.4172/2155-6121.1000116.
Life-threatening anaphylactic emergencies are largely unpredictable. Adrenaline is widely accepted as first-line therapy for anaphylaxis, due to its physiological effects in reversing symptoms of anaphylaxis and with studies showing both reductions in morbidity and mortality associated with its administration.
Anaphylaxis can prove fatal, therefore learning how to use an adrenaline auto-injector is crucial for people with allergies and parents of children who have previously suffered from anaphylaxis. Such people must carry an adrenaline autoinjector with them at all times for administration when required.
It is surprising that there are currently no internationally accepted criteria, including International Organization of Standards or other governmental regulatory requirements to benchmark the performance of adrenaline auto-injectors under standard conditions as there are for insulin pen injectors.
For patients experiencing an anaphylactic emergency it is vital that a sufficient amount of the life saving drug, adrenaline, is promptly delivered to the correct tissue compartment in minimal time to ensure maximal clinical benefit.
Further research is needed to evaluate the quality and efficacy of these devices prior to approval.
There is also an urgent need for governmental regulatory authorities throughout the world to provide guidelines on the manufacture and testing of these devices prior to grant marketing authorization.
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Copyright: © 2011 Ram FSF. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Να υπενθυμίσουμε μία παλαιότερη, εξαιρετικά ενδιαφέρουσα δημοσίευση από έναν διεθνώς καταξιωμένο ερευνητή, τον καθηγητή Anthony J. Frew :
What are the ‘ideal’ features of an adrenaline (epinephrine) auto-injector in the treatment of anaphylaxis?
Allergy. 2011 Jan;66(1):15-24.
Anaphylaxis is a systemic allergic reaction that often involves respiratory symptoms and cardiovascular collapse, which are potentially life-threatening if not treated promptly with intramuscular adrenaline. Owing to the unpredictable nature of anaphylaxis and accidental exposure to allergens (such as peanuts and shellfish), patients should be prescribed intramuscular adrenaline auto-injectors and carry these with them at all times. Patients also need to be able to use their auto-injectors correctly while under high stress, when an anaphylactic attack occurs. Despite this, an alarming number of patients fail to carry their auto-injectors and many patients, carers of children with known anaphylaxis and healthcare professionals do not know how to use the device correctly, despite having had training. Currently available auto-injector devices have various limitations that may impede their use in the management of anaphylaxis. There is also a lack of validated assessment criteria and regulatory requirements for new devices. This review describes the different delivery systems used in currently available auto-injectors and discusses the key barriers to the use of adrenaline auto-injectors, with the goal of identifying the ‘ideal’ features/characteristics of such devices in the emergency treatment of anaphylaxis that will ensure ease of use, portability and accurate delivery of a life-saving drug.
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Copyright: Allergy 66 (2011) 15–24 © 2010 John Wiley & Sons A/S.