epipen administration guide
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epipen administration guideWe can't connect to the server for this app or website at this time. There might be too much traffic or a configuration error. Try again later, or contact the app or website owner. By continuing to use this website, you consent to our use of these cookies. You can find out more about how we use cookies and how to manage them by reading our Cookie Policy. Just in case you have an allergic reaction and need to act quickly. Mylan is not responsible for the content of the site you are about to visit. This includes any possible side effects not listed in the package leaflet. The immediate administration of epinephrine is critical for all patients meeting any of the three criteria outlined in the Reports of patients receiving epinephrine for food-induced or non-food-induced anaphylaxis note that as high as 10-20 of individuals who receive epinephrine will require more than 1 dose before recovery of symptoms.” 4 Biphasic reactions have been reported to occur in 1-20 of anaphylaxis episodes and typically occur about 8 hours after the first reaction, although recurrences have been reported up to 72 hours later.” 4 See Terms and Conditions. In conjunction with the administration of epinephrine, the patient should seek immediate medical or hospital care. More than two sequential doses of epinephrine should only be administered under direct medical supervision. Do not inject intravenously, into buttock, or into digits, hands, or feet. Instruct caregivers to hold the leg of young children firmly in place and limit movement prior to and during injection to minimize risk of injection-related injury. Advise patients to seek medical care if they develop symptoms of infection such as persistent redness, warmth, swelling, or tenderness at the injection site. Arrhythmias, including fatal ventricular fibrillation, have been reported, particularly in patients with underlying cardiac disease or taking cardiac glycosides, diuretics, or anti-arrhythmics.http://www.hotelscalicut.com/userfiles/fanuc---s--420if-manual.xml
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Selection of the appropriate dosage strength is determined according to body weight. Click here for Full Prescribing Information for the Authorized Generic for EpiPenAnaphylaxis in America:Guidelines for the diagnosis andEpinephrine and its use in anaphylaxis: current issues.J Asthma Allergy Educ. 2012;3(4):178-181. Second symposium on the definition andJ Allergy Clin Immunol. 2006;117(2):391-397. MB, et al; World Allergy Organization. World Allergy Organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J. 2011;4(2):13-37.Anaphylaxis—a practice parameterAnaphylaxis—a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-384. See latest edition here. Join our mailing list: All content is subject to copyright for the Australasian Society of Clinical Immunology and Allergy. Read more. The content provided is for education, communication and information purposes only and is not intended to replace or constitute medical advice or treatments. Read more. Read our privacy policy here. Any link to a third-party website does not imply any endorsement by ASCIA. Please upgrade your browser to improve your experience. You should be confident that you know exactly how to use the device. Always use this medicine exactly as your doctor or pharmacist has told you. You will need to go to hospital for observation and further treatment as required. Unconscious patients should be placed on their side in the recovery position. Patients should remain with another person until medical assistance arrives. Ask someone to stay with you until the ambulance arrives in case you feel unwell again. Familiarise yourself with these simple steps and watch the demonstration video so you are clear about what to do in an emergency. Flip open the lid on the carry case. Massage the injection area for 10 seconds. Dial 112, ask for ambulance, state anaphylaxis. Do not get up, stay lying down or seated until you have been assessed by a paramedic.http://www.broadviewlibrary.org/uploaded_bvlib/fantom-xr-manual-pdf.xml Sometimes a single dose of adrenaline may not be sufficient to completely reverse the effects of a serious allergic reaction. Please check and try again Please check and try again A message has been sent to your recipient's email address with a link to the content webpage.If you think you or someone you know is experiencing an anaphylaxis, use the adrenaline autoinjector immediately then call an ambulance on triple zero (000). They are designed to administer a single, fixed dose of adrenaline and can be given by anyone, including people who are not medically trained. Both brands have an autoinjector for adults and one, which contains a lower dose of adrenaline, for children who weigh between 15kg and 30kg. It also relaxes the lungs to help breathing, and reduces swelling, skin rashes and itching. If breathing is difficult, they can sit on the ground. Keep your fingers and thumb away from the orange tip. Hold the autoinjector at a right-angle to the outer part of the thigh. Failing to treat anaphylaxis can be life threatening. Call an ambulance on triple zero (000) and continue first aid for both asthma and anaphylaxis until the ambulance arrives. This is a short, easy to follow one-page document that sets out how to treat anaphylaxis in an emergency. Your anaphylaxis action plan is filled out and signed by a health professional, such as a doctor or nurse. Ask your doctor for a prescription. Make sure your device has not passed its expiry date before you use it. Do not use it if the adrenaline looks cloudy. Visit healthdirect’s Symptom Checker, an online tool that will help you check your symptoms and get advice on what to do. Many individuals, parents and caregivers are concerned about the stability of adrenaline in temperatures over 25oC.Know the allergens, how to avoid the allergens and how to treat a reaction (including how to use an adrenaline autoinjector).Please check and try again Please check and try again A message has been sent to your recipient's email address with a link to the content webpage.Select a symptom, answer some questions, get advice. Please enter manually below. Please enter manually below. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information. We’re committed to providing reliable COVID-19 resources to keep you informed and safe. In 2017, Mylan N.V. announced a recall of more than a dozen batches of pens related to a malfunction. The company also faced criticism after several price increases and drug shortages. The FDA approved a generic version of the pen in August 2018. PRN is a nationally recognized leader in providing independent medical reviews. These reactions may come from insect bites, food allergies, exercise or unknown triggers. The most serious of these conditions is anaphylaxis, a life-threatening allergic reaction that happens when the immune system overreacts to an allergen. Anaphylaxis can cause drops in blood pressure and difficulty breathing. The original EpiPen is for patients who weigh 66 pounds or more, while EpiPen Jr.Schools are required to have a supply on hand, and about 70 percent of these prescriptions go to children who are under 18 years old. The company sells an “authorized generic” version of EpiPen, which is actually the same pen but in unbranded packaging. But some common side effects seen in existing literature include anxiety, restlessness, heart palpitations, headaches and nausea. But Mylan has previously recalled the auto-injectors because of malfunctions. The patient’s weight determines the dose. Each auto-injector comes in a clear carrying tube. Before use, patients or people administering the medicine to young children need to remove the pen from the tube. To help people remember this, Mylan uses the phrase, “blue to the sky, orange to the thigh.” Hold the leg of young children firmly in place before and during injection to prevent injuries.” Mylan provides an empty, needleless training injector marked “Trainer” with each pack of EpiPens for people to practice injecting the medicine. Patients should call 911, see their doctor or go to the emergency room immediately after using the pen. EpiPen instructions say it is safe to administer a second injection five to fifteen minutes after the first. But people should not have more than two injections right after one another without medical supervision. Patients may also suffer stroke, high blood pressure or death. Seek medical attention right away in the case of a possible overdose. However, the medication insert lists a few things to look out for when using the auto-injectors. For example, intravenous use can cause cranial hemorrhages, and the medication will not work properly if injected into the buttocks. Bacteria on the skin at the time of injection may be responsible. An alcohol swab may reduce the risk of infection, but alcohol doesn’t kill all types of microorganisms. Avoid injecting pens into the buttocks to reduce risk. People with heart disease, arrhythmias, hypertension or people who take drugs that may create arrhythmias may be at greater risk of chest pain or ventricular arrhythmias after using EpiPen. These include heart medications, antidepressants, beta-adrenergic blocking drugs (propranolol), alpha-adrenergic blocking drugs (phentolamine) and ergot alkaloids (dihydroergotamine, ergotamine). A week after the initial recall, Mylan announced that Meridian had recalled thousands more EpiPens that had been distributed in the United States. The recalls were announced after reports that a defective part could cause them to malfunction. The companies distributed the pens between December 2016 and July 2017. The expiration dates on the affected devices ranged from April 2017 to October 2017. Do you have any thoughts you'd like to share about Drugwatch.com? One of our content team members will be in touch with you soon. One of our content team members will be in touch with you soon. PRN is a nationally recognized leader in providing independent medical reviews. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and women’s health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include: Review our editorial policy to learn more about our process for producing accurate, current and balanced content. Retrieved from Retrieved from Retrieved from Retrieved from Retrieved from Retrieved from Warning Letter. Retrieved from. Retrieved from We will direct you to one of our trusted legal partners for a free case review. For more information, visit our partners page. It is not a substitute for professional medical advice, diagnosis or treatment. Any unauthorized or illegal use, copying or dissemination will be prosecuted. Please read our disclaimer for more information about our website. Prior results do not predict a similar outcome. For more information, visit our partners page. However, as required by the new California Consumer Privacy Act (CCPA), you may record your preference to view or remove your personal information by completing the form below. Anaphylaxis is unpredictable. The severity of future anaphylactic reactions cannot be accurately predicted based on the level of sIgE, the size of the skin prick test wheal or the severity of past reaction. 1,2 In addition: Familiarity with the Trainer is key, as epinephrine auto-injectors are often used under stressfulSee Terms and Conditions. In conjunction with the administration of epinephrine, the patient should seek immediate medical or hospital care. Instruct caregivers to hold the leg of young children firmly in place and limit movement prior to and during injection to minimize risk of injection-related injury. Advise patients to seek medical care if they develop symptoms of infection such as persistent redness, warmth, swelling, or tenderness at the injection site. Arrhythmias, including fatal ventricular fibrillation, have been reported, particularly in patients with underlying cardiac disease or taking cardiac glycosides, diuretics, or anti-arrhythmics. Selection of the appropriate dosage strength is determined according to body weight. Click here for Full Prescribing Information for the Authorized Generic for EpiPenGuidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(6 Suppl):S1-S58. J Allergy Clin Immunol. 2009;124(4):625-636. J Asthma Allergy. 2014;7:95-104. Curr Allergy Asthma Rep. 2012;12(6):641-649. Ann Allergy Asthma Immunol. 2015;115(5):341-384. Rochester, MN: Mayo Foundation for Medical Education and Research; 2009. J Asthma Allergy Educ. 2012;3(4):178-181. Second-phase reactions can occur even following administration of corticosteroids. For the next 48 hours, patients must stay close to a hospital or where they can call 911. Multiple doses of epinephrine are also required for long-lasting or protracted anaphylaxis, which is frequently associated with low blood pressure (profound hypotension) and sometimes lasts longer than 24 hours. Protracted anaphylaxis is minimally responsive to aggressive therapy and has a poor prognosis. If the expiry date is less than 12 months, Pfizer recommends patients to ask the pharmacist to dispense a longer-dated device. Instruct patients to replace their auto-injector immediately if it is discoloured or brown or contains sediment (a precipitate).Hold child's leg firmly during injection The prescribing information is also available by calling 1-800-463-6001. Please enable scripts and reload this page. Epinephrine is a life-saving drug that treats the symptoms of a severe allergic reaction by stopping the airway from swelling. While auto-injectors are designed to be easy to use, parents and caregivers who may need to use one on a child should be trained by a medical provider at least once a year. When using an auto-injector, remember to follow the instructions printed on the package. Here is a summary of the steps to use three different epinephrine auto-injectors in an emergency: Instructions for EpiPen: Take the epinephrine auto-injector out of its package. Remove the blue safety cap. Hold the auto-injector in your fist. The needle comes out of the orange end, so be careful not to hold your hand over the end. Push the end with the needle firmly against the side of the child's thigh, about halfway between the hip and knee. Inject the medicine into the fleshy outer portion of the thigh. Do not inject into a vein or the buttocks. You can give the injection through clothes or on bare skin. Hold the auto-injector in place until all the medicine is injected—usually no more than 3 seconds. Remove the needle by pulling the pen straight out. A protective shield will cover the needle as soon as it is removed from the thigh. Put the injector back into its safety tube. Give it to EMS when they arrive. Massage the area after the injection.? ?Instructions for Auvi-Q Pull Auvi-Q out of the case. Place the black end firmly against the side of the child's thigh, about halfway between the hip and knee. Hold the leg firmly in place before and during the injection. Hold the auto-injector in place for the 2 second countdown. Remove the needle by pulling the Auvi-Q straight out. Put the Auvi-Q back into its case. Massage the area after the injection. Instructions for the Adrenaclick Pull off the gray caps off both ends. The needle will come out of the red tip. Place the red tip firmly against the side of the child's thigh, about halfway between the hip and knee. Hold the auto-injector in place for 10 seconds. Remove the needle by pulling the Adrenaclick straight out. If the needle is exposed, then the dose was given. If the needle is not exposed, repeat steps 2-4. Put the Adrenaclick back into its case. Massage the area after the injection.There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. It comes on quickly and can be fatal. All rights reserved. EpiPen and EpiPen Jr are disposable, pre-filled auto-injectors used to treat life-threatening, allergic emergencies including anaphylaxis in people who are at risk for or have a history of serious allergic emergencies. Each device contains a single dose of epinephrine. EpiPen and EpiPen Jr are for immediate self (or caregiver) administration and do not take the place of emergency medical care. You should get emergency help right away after using EpiPen and EpiPen Jr. EpiPen and EpiPen Jr are for people who have been prescribed this medicine by their healthcare provider. The EpiPen Auto-Injector (0.3 mg) is for patients who weigh 66 pounds or more (30 kilograms or more). The EpiPen Jr Auto-Injector (0.15 mg) is for patients who weigh about 33 to 66 pounds (15 to 30 kilograms). It is not known if EpiPen and EpiPen Jr are safe and effective in children who weigh less than 33 pounds (15 kilograms). What are the possible side effects of the EpiPen and EpiPen Jr. EpiPen and EpiPen Jr may cause serious side effects. The EpiPen or EpiPen Jr should only be injected into the middle of your outer thigh (upper leg). Do not inject the EpiPen or EpiPen Jr into your: If you accidentally inject EpiPen or EpiPen Jr into any other part of your body, go to the nearest emergency room right away. Tell the healthcare provider where on your body you received the accidental injection.Some of these infections can be serious. Call your healthcare provider right away if you have any of the following at an injection site: redness that does not go away swelling tenderness the area feels warm to the touch Cuts on the skin, bent needles, and needles that remain in the skin after the injection, have happened in young children who do not cooperate and kick or move during an injection. If you inject a young child with EpiPen or EpiPen Jr, hold their leg firmly in place before and during the injection to prevent injuries. Ask your healthcare provider to show you how to: Hold the young child firmly in place (restrain). With 1 hand, grip the auto-injector with the orange tip pointing down. With the other hand, pull the blue safety release straight up and away from the auto-injector. If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have longer lasting side effects when you use your EpiPen or EpiPen Jr. Talk to your healthcare provider about all your medical conditions. Common side effects of EpiPen and EpiPen Jr include: fast, irregular or “pounding” heartbeat sweating headache weakness shakiness paleness feelings of over excitement, nervousness or anxiety dizziness nausea or vomiting breathing problems These side effects may go away with rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of the EpiPen or EpiPen Jr. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. DESCRIPTION EpiPen ( epinephrine injection, USP) 0.3 mg and EpiPen Jr (epinephrine injection, USP) 0.15 mg ar e auto-injectors and combination products containing drug and device components. Each EpiPen Auto-Injector, 0.3 mg delivers a single dose of 0.3 mg epinephrine from epinephrine injection, USP 1:1000 (0.3 mL) in a sterile solution. Each EpiPen Jr Auto-Injector, 0.15 mg delivers a single dose of 0.15 mg epinephrine from epinephrine injection, USP 1:2000 (0.3 mL) in a sterile solution. The EpiPen and EpiPen Jr each contain 2 mL epinephrine solution. Approximately 1.7 mL remains in the auto-injector after activation, but is not available for future use, and should be discarded. Each 0.3 mL in the EpiPen Auto-Injector contains 0.3 mg epinephrine, 1.8 mg sodium chloride, 0.5 mg sodium metabisulfite, hydrochloric acid to adjust pH, and Water for Injection. The pH range is 2.2-5.0. Each 0.3 mL in the EpiPen Jr Auto-Injector contains 0.15 mg epinephrine, 1.8 mg sodium chloride, 0.5 mg sodium metabisulfite, hydrochloric acid to adjust pH, and Water for Injection. The pH range is 2.2-5.0. Epinephrine is a sympathomimetic catecholamine. Replace EpiPen and EpiPen Jr if the epinephrine solution appears discolored (pinkish or brown color), cloudy, or contains particles.EpiPen and EpiPen Jr are intended for immediate administration in patients who are determined to be at increased risk for anaphylaxis, including individuals with a history of anaphylactic reactions. Anaphylactic reactions may occur within minutes after exposure and consist of flushing, apprehension, syncope, tachycardia, thready or unobtainable pulse associated with a fall in blood pressure, convulsions, vomiting, diarrhea and abdominal cramps, involuntary voiding, wheezing, dyspnea due to laryngeal spasm, pruritus, rashes, urticaria or angioedema. EpiPen and EpiPen Jr are intended for immediate administration as emergency supportive therapy only and are not a substitute for immediate medical care. Each EpiPen or EpiPen Jr is a single-dose epinephrine injection for single use. Since the doses of epinephrine delivered from EpiPen or EpiPen Jr are fixed, consider using other forms of injectable epinephrine if doses lower than 0.15 mg are deemed necessary. With severe persistent anaphylaxis, repeat injections with an additional EpiPen or EpiPen Jr may be necessary. The epinephrine solution in the clear window of the EpiPen or EpiPen Jr Auto-Injector should be inspected visually for particulate matter and discoloration. Discarding After Use The EpiPen and EpiPen Jr each contain 2 mL epinephrine solution. Approximately 1.7 mL remains in the auto-injector after activation, but is not available for future use, and should be discarded. Storage And Handling Protect from light. Epinephrine is light sensitive and should be stored in the carrier tube provided to protect it from light. Do not refrigerate. Before using, check to make sure the solution in the auto-injector is clear and colorless. Replace the auto-injector if the solution is discolored (pinkish or brown color), cloudy, or contains particle. Properly dispose all used, unwanted or expired EpiPen and EpiPen Jr auto-injectors. Manufactured by: Meridian Medical Technologies, Inc., Columbia, MD 21046, U.S.A., a Pfizer company. Revised: Dec 2020 Adverse reactions reported in observational trials, case reports, and studies are listed below. Rare cases of stress cardiomyopathy have been reported in patients treated with epinephrine. Adverse reactions experienced as a result of accidental injections may include increased heart rate, local reactions including injection site pallor, coldness and hypoesthesia or injury at the injection site resulting in bruising, bleeding, discoloration, erythema or skeletal injury.Discover Your Allergy Triggers Beta-Adrenergic Blockers The cardiostimulating and bronchodilating effects of epinephrine are antagonized by betaadrenergic blocking drugs, such as propranolol. Alpha-Adrenergic Blockers The vasoconstricting and hypertensive effects of epinephrine are antagonized by alphaadrenergic blocking drugs, such as phentolamine. Ergot Alkaloids Ergot alkaloids may also reverse the pressor effects of epinephrine. Do Not Inject Intravenously Large doses or accidental intravenous injection of epinephrine may result in cerebral hemorrhage due to sharp rise in blood pressure. Rapidly acting vasodilators can counteract the marked pressor effects of epinephrine if there is such inadvertent administration. Do Not Inject Into Buttock Injection into the buttock may not provide effective treatment of anaphylaxis. Advise the patient to go immediately to the nearest emergency room for further treatment of anaphylaxis. Additionally, injection into the buttock has been associated with Clostridial infections (gas gangrene). Cleansing with alcohol does not kill bacterial spores, and therefore, does not lower this risk. Do Not Inject Into Digits, Hands Or Feet Since epinephrine is a strong vasoconstrictor, accidental injection into the digits, hands or feet may result in loss of blood flow to the affected area. Advise the patient to go immediately to the nearest emergency room and to inform the healthcare provider in the emergency room of the location of the accidental injection. Hold Leg Firmly During Injection Lacerations, bent needles, and embedded needles have been reported when EpiPen and EpiPen Jr have been injected into the thigh of young children who are uncooperative and kick or move during an injection. To minimize the risk of injection related injury when administering, hold the child’s leg firmly in place and limit movement prior to and during injection. Serious Infections At The Injection Site Rare cases of serious skin and soft tissue infections, including necrotizing fasciitis and myonecrosis caused by Clostridia (gas gangrene), have been reported at the injection site following epinephrine injection for anaphylaxis. Clostridium spores can be present on the skin and introduced into the deep tissue with subcutaneous or intramuscular injection. While cleansing with alcohol may reduce presence of bacteria on the skin, alcohol cleansing does not kill Clostridium spores. Advise patients to seek medical care if they develop signs or symptoms of infection, such as persistent redness, warmth, swelling, or tenderness, at the epinephrine injection site. Allergic Reactions Associated With Sulfite The presence of a sulfite in this product should not deter administration of the drug for treatment of serious allergic or other emergency situations even if the patient is sulfite-sensitive. Epinephrine is the preferred treatment for serious allergic reactions or other emergency situations even though this product contains sodium metabisulfite, a sulfite that may, in other products, cause allergic-type reactions including anaphylactic symptoms or life-threatening or less severe asthmatic episodes in certain susceptible persons. The alternatives to using epinephrine in a life-threatening situation may not be satisfactory. Disease Interactions Some patients may be at greater risk for developing adverse reactions after epinephrine administration. Despite these concerns, it should be recognized that the presence of these conditions is not a contraindication to epinephrine administration in an acute, life-threatening situation. Patients With Heart Disease Epinephrine should be administered with caution to patients who have heart disease, including patients with cardiac arrhythmias, coronary artery or organic heart disease, or hypertension. Other Patients And Diseases Epinephrine should be administered with caution to patients with hyperthyroidism, diabetes, elderly individuals, and pregnant women. Patients with Parkinson’s disease may notice a temporary worsening of symptoms. Patient Counseling Information See FDA-Approved Patient Labeling ( PATIENT INFORMATION And Instructions for Use ) A healthcare provider should review the patient instructions and operation of EpiPen and EpiPen Jr in detail, with the patient or caregiver. Epinephrine is essential for the treatment of anaphylaxis. Patients who are at risk of or with a history of severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens, as well as idiopathic and exercise-induced anaphylaxis, should be carefully instructed about the circumstances under which epinephrine should be used. EpiPen should be injected into the middle of the outer thigh (through clothing, if necessary). Each device is a single-use injection. Advise patients to seek immediate medical care in conjunction with administration of EpiPen. Instruct caregivers to hold the leg of young children firmly in place and limit movement prior to and during injection. This small part may pose a choking hazard for children. Complete patient information, including dosage, directions for proper administration and precautions can be found inside each EpiPen or EpiPen Jr carton. A printed label on the surface of EpiPen shows instructions for use and a diagram depicting the injection process. The Trainer may be used multiple times. A Trainer device is provided in 2-Pak cartons. Adverse Reactions Epinephrine may produce symptoms and signs that include an increase in heart rate, the sensation of a more forceful heartbeat, palpitations, sweating, nausea and vomiting, difficulty breathing, pallor, dizziness, weakness or shakiness, headache, apprehension, nervousness, or anxiety. These signs and symptoms usually subside rapidly, especially with rest, quiet and recumbency. Patients with hypertension or hyperthyroidism may develop more severe or persistent effects, and patients with coronary artery disease could experience angina. Patients with diabetes may develop increased blood glucose levels following epinephrine administration. Accidental Injection Advise patients to seek immediate medical care in the case of accidental injection. Storage And Handling Instruct patients to inspect the epinephrine solution visually through the clear window of the auto-injector periodically.