Treatment of anaphylaxis: EpiPen, Twinject or another autoinjector?

Anaphylaxis is an extreme and severe whole body allergic reaction, caused by food or non-food allergens, such as peanuts, treenuts, sesame, shellfish, fish, dairy, eggs, latex, penicillin, and bee or wasp stings, to name a few. Anaphylaxis can occur from a few minutes to a few hours after exposure to an allergen, and symptoms include difficulty breathing, nausea, vomiting, and swelling of the lips, throat and tongue. Anaphylaxis can proceed rapidly to death, and swift treatment with epinephrine injections is vital to save lives, but in spite of this, EpiPen use is low. Statistics show that 3 in 10 people use an EpiPen after anaphylactic reactions, and only one in ten use their EpiPen when symptoms first appear, and there appears to be anxiety due to inadequate knowledge of how to use the EpiPen.

Some time it can take more than one dose of epinephrine to successfully treat a reaction, and some patients are advised to carry two EpiPens or one Twinject. However these devices also have a maximum expiry date of only one year, which delivers a heavy cost to national health services, as well as the environmental/pollution problem of dealing with the old plastic pens.

Scientists from the University of Montreal and McGill University in Montreal, Canada, suggest that a new system for delivering multiple injections could be developed, based on a similar system already in use for diabetics, using disposable cartridges. The EpiPen and Twinject needles, currently 5/8” long, need to be increased to 7/8” in order to reach the muscles adequately, given that the intramuscular route provides the most successful treatment.

Source: Official Publication of the College of Family Physicians of Canada

First Published in May 2011


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