Original Articles: Food and Drug Reactions and AnaphylaxisEpiPen Jr versus EpiPen in young children weighing 15 to 30 kg at risk for anaphylaxis☆,☆☆
Section snippets
Methods
The study was approved by the University of Manitoba Research Ethics Board. Assent for participation was obtained from each child; written, informed consent for each child's participation was obtained from his or her parents.
Results
A total of 153 families, each with a child aged 4 to 8 years who was at risk for anaphylaxis and for whom the EpiPen Jr or the EpiPen had been prescribed by his or her personal physician, were telephoned with regard to involvement in this study. Twelve families agreed to participate. Most of the families who were contacted declined because they did not want their children to have an epinephrine injection or a “needle.” Some parents commented that their children would never need the EpiPen Jr or
Discussion
This study was performed in a practical attempt to address the dilemma faced by physicians involved in the care of young children at risk for anaphylaxis outside a hospital setting: how to decide which of the 2 available fixed doses of epinephrine (either 0.15 mg from an EpiPen Jr or 0.3 mg from an EpiPen) to prescribe for a young child weighing between 15 and 30 kg for whom neither dose would be optimal. We have shown that epinephrine injected either from an EpiPen Jr (0.15 mg) or an EpiPen
Acknowledgements
We are grateful to the children who participated in this study and to their parents. We thank Ms Lana M. Johnston, RN, for excellent professional assistance and Janet R. Roberts, MD, FRCPC, Wade T. A. Watson, MD, FRCPC, and Allan B. Becker, MD, FRCPC, for allowing us to study their patients.
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2020, Journal of Allergy and Clinical Immunology: In PracticeEpinephrine, auto-injectors, and anaphylaxis: Challenges of dose, depth, and device
2018, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :However, no pharmacokinetic studies involving patients in anaphylaxis, where drug pharmacokinetics might be substantially different because of extravascular fluid losses and other physiologic changes, have been published, nor have any true pharmacodynamic studies. In the only study approaching a dose response study, EpiPen and EpiPen Jr devices were used in 12 healthy children weighing between 15 and 30 kg, according to which device had been prescribed for them.12 Side effects were more frequent and more severe in children receiving epinephrine 0.01 to 0.014 mg/kg than in those receiving epinephrine 0.008 to 0.009 mg/kg.
Epinephrine auto-injector needle lengths: Can both subcutaneous and periosteal/intraosseous injection be avoided?
2018, Annals of Allergy, Asthma and Immunology
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Supported by the Children's Hospital Foundation of Manitoba, Inc. No financial or in-kind support was provided for this study by any corporate sponsor.
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Reprint requests: F. E. R. Simons, MD, FRCPC, Children's Hospital of Winnipeg, 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9.