Friday 5 October 2018

EPINEPHRINE – AN AUTOINJECTOR FOR INFANTS AND TODDLERS


Epinephrine is the drug of choice in the treatment of anaphylaxis and is available in many parts of the world in the form of epinephrine autoinjectors for self-treatment [1]. However, when prescribing these devices, clinicians must teach patients how and when to use them and dispel fears about adverse effects. Autoinjectors may be lifesaving for patients but only if patients are willing and able to use these devices effectively.


Children with serious allergies require access to injectable epinephrine, but the standard dose available in Pediatric Autoinjectors (0.15 mg) is relatively high for infants and small toddlers. To deliver an ideal dose to infants, some clinicians dispense an ampule of epinephrine and a syringe, although this approach requires significant caregiver training. A lower-dose epinephrine Autoinjector that delivers 0.1 mg has been developed (Auvi-q), which is labelled for use in infants and toddlers 7.5 to 15 kg (16.5 to 33 lbs), and may be an easier option for some families.

Epinephrine is a sympathomimetic agent with multiple actions that can reverse the symptoms of anaphylaxis.

Beneficial effects — Epinephrine acts as an agonist at alpha-1 receptors to mediate increased vasoconstriction, increased peripheral vascular resistance, and decreased mucosal edema. Agonist effects at beta-2 receptors result in bronchodilation and decreased mediator release from mast cells and basophils
Adverse effects — Even when injected properly, epinephrine is often associated with minor and transient adverse effects such as tremor, dizziness, palpitations, anxiety, restlessness, and headache

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