autoinjector with adrenaline

Content:
What is autoinjector
Why allergy sufferers need adrenaline
When needed autoinjector
How to use an autoinjector
Dosage
Adrenaline injection side effects
How to store a syringe pen
Popular auto injectors
Where can one buy

The autoinjector is a disposable, automatic epinephrine syringe for intramuscular injection.

If you haven’t heard of anaphylaxis, you probably think you don’t need a syringe. Why allergy sufferers need a syringe with adrenaline (epinephrine)? After all, there are antihistamines. Diabetics usually carry syringes with them.

Well, now I’ll tell you that you are mistaken. An autoinjector for allergy sufferers is a necessary thing in the household. No kidding, an autoinjector can save your life. If you are at risk for anaphylaxis, get to know him better, be friends with him and do not let him go far away from you.

My baby was 1.5 years old when he touched cashews and rubbed his eyes with his hands. The reaction developed in a couple of minutes – the face was swollen, it became difficult to breathe. I don’t know how I didn’t faint.

In that case, Suprastin helped us. Now I understand that we are lucky. Suprastin is not the best choice for first aid for anaphylaxis. Let me explain why.

During an attack of anaphylaxis, blood pressure may decrease, and Suprastin lowers the pressure even more, sometimes critically. Therefore, it is dangerous, and therefore it is prohibited (as a remedy for anaphylaxis) in developed countries. Link to the source.

We took suprastin on the advice of a pediatrician. I do not know what is the matter here, in the ignorance of doctors or the protocol of treatment.

Okay, as time went on and I learned more about anaphylaxis. I bought an ampoule with adrenaline at the pharmacy, a disposable syringe, packed it in a purse and always carried it with me. The dosage was agreed with the allergist and recorded on the box.

I lived quietly until one incident happened. In the cafe, the girl felt bad. The fish provoked an anaphylaxis attack. The girl had adrenaline. Nearby was a medic who gave an injection. I looked at it and realized in horror that I couldn’t do that.

Just imagine: your baby begins to swell, suffocate, and every minute he gets worse. You need to unpack the tools. Are your hands shaking? Yeah.

With a confident movement, we open the ampoule, collect the required volume of liquid. The dosage is written on the box. And where is this box, my God! Well, then do everything that is done in such cases. Confident and fast.

I can’t even write about it calmly. In general, this method is not for me. Although I believe that constant training on dolls can help.

If you think that I am the only one and you will not have tantrums for sure, here is a link to the study. I’m not alone.

Let’s go further. I call a friend in Spain and tell about this case. My friend does not understand me – why do you have an ampoule in your purse? Well, of course, anaphylaxis, first aid, you must understand.

I, he says, still understand Russian well, but the Russian train of thought is no longer very good. You don’t go to the bakery in a tank. Autoinjectors have long been invented.

I went to read about a pen-syringe. Basically, I came across information about auto-injectors with insulin, but I also found something about adrenaline devices.

True, it was difficult to find an autoinjector with adrenaline in Russia at that time. I bought it in Cyprus.

In online pharmacies, prices range from $ 50 – $ 500. You can store it for 12 months, observing the conditions. More on this below.

What is autoinjector

What is autoinjector

Nothing complicated. An autoinjector looks like a cute marker with a surprise (needle) inside. Doesn’t sound like a nightmare nurse’s sinister tool at all. Remove the covers – the fuses and the device is ready for action.

  1. There is no need to calculate the dosage.
  2. It is not necessary to gain adrenaline from the ampoule.
  3. It is not necessary to squeeze air out of the syringe.

Save time. And with anaphylaxis, time, without exaggeration, is life. Link to source

The needle in the autoinjector is spring-loaded, works automatically. In some devices you have to press the button (Anapen), in others it is enough to hit the thigh with a syringe (EpiPen or Jext).

Marketers are awake and you can already buy a device with an electronic needle release system or voice guidance (Auvi-Q).

An important parameter is the length of the needle in the syringe. You don’t need to take off your clothes to inject. Link to source

The very idea of a quick and carefree self-injection has long been known. Think of war films. The soldier injects himself through his clothes and runs on.

The military can also be useful 🙂

Why allergy sufferers need adrenaline

adrenaline

Adrenaline, also known as epinephrine, relieves shock during an anaphylaxis attack. It works quickly and relieves the most dangerous symptoms: swelling of the throat, shortness of breath, increases blood pressure, stabilizes the cells that secrete histamine.

The sooner the allergic person receives an adrenaline injection, the better.

I’m sure you know other medicines that are used for allergic reactions: antihistamines, bronchodilators.

All of them are good and useful for their cases. But they will not be able to completely stop the attack of anaphylaxis. Link to the source.

Antihistamines save you from itching and hives, inhalers can help get rid of coughs and wheezing. But especially dangerous symptoms – throat swelling and low blood pressure – will only remove adrenaline.

Anaphylaxis develops quickly, and hormones and antihistamines in tablets, drops, syrups act slowly. With all the desire, they simply may not have time to help.

When needed autoinjector

When needed autoinjector

We already know the answer to this question – Always.
If there is a risk of getting an attack of anaphylaxis, a felt-tip pen with adrenaline should be in your pocket.

Doctors agree with us. Here’s the Link

Well, in more detail. For the corrosive.

Anaphylaxis is unpredictable. The reaction can come at any time. For what? For fried fish in a restaurant, for cold medicine, for grandma’s bun, for latex gloves, for a bee sting, for a run in the park. The list goes on. Trust me, he’s impressive. Link to source

Our pediatrician had anaphylactic shock on a treadmill. Reaction to physical activity. Employees of the fitness club provided assistance to her. She could not help herself.

And here’s another interesting thing, sometimes the same allergen in the same person provokes mild symptoms, and sometimes a life-threatening attack. Why is that? I do not know. And scientists also don’t know yet.

But we know exactly who is at risk for anaphylaxis:

  • who already had anaphylaxis;
  • who have had any violent reaction to an allergen. But there is no certainty that it was anaphylaxis;
  • if there was a mild reaction to allergens that most often cause anaphylaxis (peanuts, fish, milk, wheat, insect poison, soy);
  • if allergy symptoms get worse each time;
  • who suffers from symptoms of severe eczema. Source link;
  • have asthma;
  • who are taking beta blockers or other medicines that increase the risk of a severe reaction.

Oh, allergies are insidious, friends. If an allergy sufferer has never had anaphylaxis, no one can predict when the attack will be for the first time. This can happen at any time.

But an allergy sufferer can and should do something. After the first severe attack of allergies, the allergy sufferer must recognize the allergens that threaten his life. There is no point in walking through life like a minefield.

Guessing on the stars is not required, you have to go to an allergist. Most often, the doctor will immediately determine the cause of the anaphylaxis. But sometimes you will need to pass skin tests or a component molecular allergy test.

After testing, get a list of 300 allergens with possible reactions and cross-reactions.

Test results will show protein allergens to watch out for, but they won’t tell you when to expect an attack. Without symptoms, the numbers on the test results mean nothing.

Let me give you an example. As you remember, my son had anaphylaxis for nuts. The test results showed a reaction to proteins – allergens that caused the attack. Everything is clear – you can’t find fault.

And at the same time, my friend’s daughter has the same testing shows a reaction to the same nut proteins. She has not yet had anaphylaxis and is not afraid to eat nuts. But the risk still remains and is not small. Therefore, my friend bought a syringe with adrenaline and does not part with it.

By the way, at the dentist’s office they usually ask the question – have you had any allergic reactions to medications? It wasn’t, it doesn’t mean that it won’t. They can even send blood to donate for anesthetics. It will not help either (if there was no anaphylaxis for drugs before).

Do they have adrenaline in the clinic?

Well, you already know what I’m getting at. Keep your autoinjector in your pocket.

In fact, you can talk about anaphylaxis for a long time. We will talk about it in more detail in the next article.

I hope I have not caught up with fear on you? Let’s continue.

How to use an autoinjector

How to use an autoinjector

Well, we got to the most interesting part.

Before injecting yourself with anything, do not forget to consult with an allergist. Work with your doctor to make a plan of action in the event of an attack (be sure to write it down) and adjust the dosage of adrenaline.

It is even better if the allergist can show you how everything should be done. There may be an injection simulator in the doctor’s office. Don’t miss a chance, practice. The theory in an emergency will wear off, but the practice will remain.

There are manufacturers of autoinjectors that supply a training device (without a needle and medicine) complete with a combat syringe. If a simulator is not included, it can be sent on request.

Allergist caught intractable? Practice at home. An autoinjector is still not a toothpick, if you act carelessly, it can leave a lacerated wound.

How to use an autoinjector

And also, keep in mind that the device has a recoil. Link

Find and remember the injection place. Mentally demarcate the outer thigh with vertical and horizontal lines. The injection must be made in the upper square.

injection

Why hip? A large muscle, the medicine will immediately enter the bloodstream, while not touching large vessels or nerves.

Intramuscular injection is better than subcutaneous injection. Link to source

The injection can be done through clothing. Just make sure you don’t have a wallet in your pocket.

You cannot give an injection into a vein. A large dose of adrenaline or an accidental injection into a vein will dramatically increase blood pressure and may cause cerebral hemorrhage.

You cannot inject into the buttock. Injection into the buttock is less effective in relieving an anaphylaxis attack.

  1. Look at which side the needle is.
  2. Remove the blocker.
  3. Hold the autoinjector tube in your fist. Take care of your fingers. Adrenaline is a strong vasoconstrictor. This means that it narrows the lumens of blood vessels, especially arteries. So an accidental injection could block blood from reaching the finger. See a doctor immediately!
  4. The leg should be motionless.
  5. Hit the thigh hard with the autoinjector (until it clicks) and press firmly. Prepare to give back.
  6. Important! Do not pull out the autoinjector immediately after clicking, wait 10 seconds.
  7. Massage the injection site for 10 seconds.
  8. Be sure to call an ambulance after the injection. Tell your doctor that you have received an epinephrine injection.

Allergists advise carrying two or more syringes. The first attack may be followed by a second. Remember? Link.

When you give the injection, you may notice that a little adrenaline is left in the autoinjector. Don’t be alarmed, you’ve got the right dose. The syringe is disposable and you cannot do a second injection.

Adrenaline dosage

Adrenaline dosage

Your allergist will tell you about the dosage. Usually, the dosage of epinephrine is calculated by weight, but it can be individualized if there have already been severe reactions.

Auto-syringes are usually available in two dosages: 0.15 mg. and 0.3 mg.

EMERADE auto-injectors are available with a dosage of 0.5 mg. – for adults, incl. with a lot of weight.
Auvi-Q is available in 0.1mg dosages. – for babies.

Adults
Dosage 0.3 mg. designed for adults and children weighing 30 kg.

Overweight adults
Fat people should definitely carry several dosages of 0.3 mg adrenaline with them. or better 0.5 mg.

For children
A dosage of 0.15 mg is suitable for children from 15 to 30 kg.

Babies
Dosage 0.1 mg – for infants and children from 7.5 to 15 kg. Link to the source.

Unfortunately, the fixed dose of epinephrine in an autoinjector makes it difficult for young children to use.

Doctors determine the dosage of adrenaline for children by the formula: 0.01 mg. for 1 kg. body weight.

And this is what happens. According to the manufacturer’s instructions, a syringe pen with a dosage of 0.15 mg. designed for a child weighing 15 to 30 kg. And if your child weighs 25 kg., According to the formula, his dosage will be 0.25 mg. So he won’t have enough adrenaline in an autoinjector?

I did some simple calculations.

A child weighing 7.5 kg. autoinjector 0.1 mg. will give 133% of the ideal (recommended) dose, and the autoinjector will give 0.15 mg. – 200%.

For a child weighing 10 kg. autoinjector 0.15 mg. will provide 150% of the ideal dose.

For a child weighing 12.5 kg. 0.1 mg. adrenaline, this is only 80% of the ideal dosage. Whereas the syringe is 0.15 mg. will give out excess 120%.

If the child weighs 20 kg., The autoinjector is 0.15 mg. delivers only 75% of the ideal dose, while the 0.3 mg autoinjector delivers 150%.

What to do in such cases? Consult your doctor.

Perhaps you will find, if you try, the results of studies that say that excessive doses of adrenaline are tolerated by children without serious consequences. For example: Link to source.

But research is research, and your doctor knows your child better. My opinion: in such matters, the recommendations of the attending physician in the first place.

Too much adrenaline can dangerously raise blood pressure, leading to stroke and death.

Special attention to those who suffer from chronic diseases: cardiovascular, diabetes mellitus, thyroid diseases, etc.

Epinephrine can affect the way medications (including antidepressants) you take. In each such case, be sure to select an individual dosage with your doctor.

Adrenaline side effects

Adrenaline side effects

There are people who are afraid of adrenaline. At the doctor’s appointment, they choke, shout – I don’t need adrenaline, I’m afraid because of it my heart will stop.

Well what can I say. Every medicine has side effects. And even ordinary vitamins.

If an attack has begun, there is no time to assess the risks. We must act. The chances of dying from a heart attack are few, but the chance of suffocating from anaphylaxis is quite real.

The effects of an adrenaline rush are few and usually end quickly.

  • Breathing and heart rate increase.
  • Chest pressure and discomfort.
  • Tremor, chills, headache.
  • Nausea, dry mouth.
  • Fear.

Autoinjector storage rules

Autoinjector storage rules

For adrenaline to help, it must be properly stored.

The reader asked me a reasonable question: why buy an expensive autoinjector when you can draw the required amount of adrenaline into a syringe at home and put it in your pocket.

And it might work. But the trouble is, epinephrine (adrenaline) quickly decomposes from contact with oxygen or if the ampoule is heated in the sun (spoiled adrenaline will turn pink or brown). There is a risk that the medicine will not work at the right time.

Therefore, please observe the storage rules and do not damage the packaging.

  1. Store the autoinjector in a sealed container at normal room temperature.
  2. Do not freeze or heat the appliance.
  3. Autoinjector is not afraid of radiographic equipment. With him you can go through security at the airport.
  4. Watch the adrenaline through a special window in the device’s tube. The liquid should be clear. If adrenaline becomes cloudy or floating particles or brown sediment are visible, replace the autoinjector with a new one.
  5. You will have to buy a new device every 12 months. Shelf life is no more than a year (the date is indicated on the package).
  6. Even if the adrenaline in the syringe is transparent as a tear.

I immediately had a question about the last point. We know that manufacturers indicate an expiration date with a margin. If it happens that I have a syringe with a slightly expired adrenaline in my hands. Will I be able to use it?

It turns out, yes. If there is no alternative, expired adrenaline is better than nothing. The main thing is that the medicine is transparent, without sediment and properly stored.

There are not many studies on this subject, but those that exist show the effectiveness of the drug (80%) after the expiration date. Link to the source.

Do not think that I am urging you to ignore the expiration date of autoinjector This information is a last resort. I am sure that it is not worth saving in matters of health.

What autoinjectors can you buy

EpiPen, EpiPen Junior

Available dosages: 0.15 mg. (green packaging), 0.3 mg. (yellow).
In Spain, EpiPen is marketed under the name Altellus.
Instruction

EpiPen

Anapen, Anapen Junior

Available dosages: 0.15 mg, 0.3 mg.
Instruction

Anapen

Adrenaclick

Available dosages: 0.15 mg, 0.3 mg.
Instruction (English)

Adrenaclick

 

Auvi-Q

  • Dosage for adults: 0.3 mg. – red packaging
  • For children weighing over 15 kg: 0.15 mg. – blue color of packaging
  • For children weighing less than 15 kg: 0.1 mg. – white color of packaging (photo)
  • The needle retracts itself.
  • The box contains an audio file with instructions. Sometimes it’s convenient.
  • Instruction.

Auvi-Q

Emerade

Available dosages: 0.15 mg, 0.3 mg, 0.5 mg.

emerade

 

Jext (ALK Abello)

Available dosages: 0.15 mg, 0.3 mg.
Instruction .

Jext (ALK Abello)

 

Adrenaline syringe

A fixed-dose syringe with epinephrine.

I have one now. There used to be an EpiPen, but it was given to the girl on the plane. She needed him more.

Adrenaline syringe

But there are also more convenient ones. SYMJEPI, for example.

SYMJEPI

I saw on sale a nice waterproof pouch for storing a set of auto injectors and something else. Maybe someone will come in handy.

Epipen-Bag

Where can one buy

Autoinjectors are not officially registered in Russia. In 2021, a syringe pen from Alk Abello approved by the Ministry of Health may appear in pharmacies.

Nowadays, auto injectors can be found in online pharmacies. In some countries – Czech Republic, Italy, Spain – you need a local doctor’s prescription to buy an adrenaline syringe. You can buy an autoinjector in France with a prescription from a Russian allergist.

The recipe is not needed in Portugal, Turkey, Cyprus. I bought my EpiPen in Cyprus. I asked for a prescription from a local allergist, made a pre-order at a local pharmacy and waited a few days.

I had no problems with the removal of the autoinjector. But it is better to take a doctor’s note in English confirming the need for the device.

If you need a prescription from a European allergist, you can try getting one from the Finnish MedFIN clinic. The clinic issues prescriptions in absentia, based on the recommendation of a Russian doctor. The price of this procedure is 50 euros.

What need to do. Get a certificate from your allergist that you need an autoinjector. Send the certificate to the clinic’s mail, it will be checked and if the Finnish physician agrees with the appointment, he will approve the purchase of an autoinjector. Get a prescription to buy an autoinjector at any EU pharmacy.

 

Autoinjector or syringe with adrenaline for allergy sufferers

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