Epinephrine in the Management of Anaphylaxis
Epinephrine is life-saving and the only first-line medication in the management of anaphylaxis. At therapeutic doses, it acts rapidly to reverse nearly all symptoms of anaphylaxis, and stabilize mast cells. The standard approved doses administered intramuscularly in the lateral thigh have a long tra...
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Veröffentlicht in: | The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2020-04, Vol.8 (4), p.1186-1195 |
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description | Epinephrine is life-saving and the only first-line medication in the management of anaphylaxis. At therapeutic doses, it acts rapidly to reverse nearly all symptoms of anaphylaxis, and stabilize mast cells. The standard approved doses administered intramuscularly in the lateral thigh have a long track record for safe and effective use, but more information is needed on epinephrine pharmacokinetics and pharmacodynamics to ensure that current dosing strategies are optimal. Epinephrine should be administered promptly once anaphylaxis is suspected, to minimize morbidity and mortality. Providers on the front-line for managing patients with life-threatening allergic reactions need clear parameters and tools to guide the appropriate use of epinephrine, which take into account the potential evolution of symptoms and signs over time. All patients at risk for anaphylaxis should carry 2 epinephrine autoinjectors and be taught and able to demonstrate how to use them. Epinephrine autoinjectors need to be affordable, readily available, and easy for patients with allergies to carry and use. Furthermore, these devices should be available to meet the needs of all patients, from small infants through large or obese adults. The ideal means for storing and delivering epinephrine in prehospital and hospital environments warrants further study, to determine how to best balance efficiency, safety, and costs. |
doi_str_mv | 10.1016/j.jaip.2019.12.015 |
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At therapeutic doses, it acts rapidly to reverse nearly all symptoms of anaphylaxis, and stabilize mast cells. The standard approved doses administered intramuscularly in the lateral thigh have a long track record for safe and effective use, but more information is needed on epinephrine pharmacokinetics and pharmacodynamics to ensure that current dosing strategies are optimal. Epinephrine should be administered promptly once anaphylaxis is suspected, to minimize morbidity and mortality. Providers on the front-line for managing patients with life-threatening allergic reactions need clear parameters and tools to guide the appropriate use of epinephrine, which take into account the potential evolution of symptoms and signs over time. All patients at risk for anaphylaxis should carry 2 epinephrine autoinjectors and be taught and able to demonstrate how to use them. Epinephrine autoinjectors need to be affordable, readily available, and easy for patients with allergies to carry and use. Furthermore, these devices should be available to meet the needs of all patients, from small infants through large or obese adults. 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At therapeutic doses, it acts rapidly to reverse nearly all symptoms of anaphylaxis, and stabilize mast cells. The standard approved doses administered intramuscularly in the lateral thigh have a long track record for safe and effective use, but more information is needed on epinephrine pharmacokinetics and pharmacodynamics to ensure that current dosing strategies are optimal. Epinephrine should be administered promptly once anaphylaxis is suspected, to minimize morbidity and mortality. Providers on the front-line for managing patients with life-threatening allergic reactions need clear parameters and tools to guide the appropriate use of epinephrine, which take into account the potential evolution of symptoms and signs over time. All patients at risk for anaphylaxis should carry 2 epinephrine autoinjectors and be taught and able to demonstrate how to use them. Epinephrine autoinjectors need to be affordable, readily available, and easy for patients with allergies to carry and use. Furthermore, these devices should be available to meet the needs of all patients, from small infants through large or obese adults. The ideal means for storing and delivering epinephrine in prehospital and hospital environments warrants further study, to determine how to best balance efficiency, safety, and costs.</description><subject>Adult</subject><subject>Adults</subject><subject>Allergies</subject><subject>Anaphylaxis</subject><subject>Anaphylaxis - drug therapy</subject><subject>Autoinjector</subject><subject>Auvi-Q</subject><subject>Benefit</subject><subject>Cost</subject><subject>Delivery</subject><subject>Disease control</subject><subject>Dosage</subject><subject>Dose</subject><subject>Edema</subject><subject>Emerade</subject><subject>Emergency medical care</subject><subject>Epinephrine</subject><subject>Epinephrine - therapeutic use</subject><subject>EpiPen</subject><subject>Generic</subject><subject>Histamine</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Infant</subject><subject>Infants</subject><subject>Injections</subject><subject>Injections, Intramuscular</subject><subject>Length</subject><subject>Management</subject><subject>Mast Cells</subject><subject>Morbidity</subject><subject>Needle</subject><subject>Patients</subject><subject>Pharmacodynamics</subject><subject>Pharmacokinetics</subject><subject>Teva</subject><issn>2213-2198</issn><issn>2213-2201</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PwzAMhiMEYtPYH-CAKnGlxU7XNJO4TNP4kIa47B6lqctSbW1JOsT-PZm2ccQH27Jev5Yfxm4REgQUj3VSa9slHHCaIE8Asws25BzTmIfZ5bnHqRywsfc1hJCYwwSu2SDlPBdC5kP2sOhsQ93ahRzZJurXFL3rRn_Slpo-aqto1uhuvd_oH-tv2FWlN57Gpzpiq-fFav4aLz9e3uazZWwmGfSxLtBkoioJRCpAaq0l5LJKkYBElaE0psBUcMyKqiKORWF4CUZiloPhkI7Y_dG2c-3Xjnyv6nbnmnBR8QnPxHQquAwqflQZ13rvqFKds1vt9gpBHRCpWh0QqQMihVwFRGHp7mS9K7ZU_q2cgQTB01FA4b9vS055Y6kxVFpHpldla__z_wVzpnWS</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Brown, Julie C.</creator><creator>Simons, Elinor</creator><creator>Rudders, Susan A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>202004</creationdate><title>Epinephrine in the Management of Anaphylaxis</title><author>Brown, Julie C. ; Simons, Elinor ; Rudders, Susan A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-ab1c56fde063608aaa8078f31e0e6f518ccb136215bffe21bbc2d0c81570c203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Allergies</topic><topic>Anaphylaxis</topic><topic>Anaphylaxis - drug therapy</topic><topic>Autoinjector</topic><topic>Auvi-Q</topic><topic>Benefit</topic><topic>Cost</topic><topic>Delivery</topic><topic>Disease control</topic><topic>Dosage</topic><topic>Dose</topic><topic>Edema</topic><topic>Emerade</topic><topic>Emergency medical care</topic><topic>Epinephrine</topic><topic>Epinephrine - therapeutic use</topic><topic>EpiPen</topic><topic>Generic</topic><topic>Histamine</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Infant</topic><topic>Infants</topic><topic>Injections</topic><topic>Injections, Intramuscular</topic><topic>Length</topic><topic>Management</topic><topic>Mast Cells</topic><topic>Morbidity</topic><topic>Needle</topic><topic>Patients</topic><topic>Pharmacodynamics</topic><topic>Pharmacokinetics</topic><topic>Teva</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brown, Julie C.</creatorcontrib><creatorcontrib>Simons, Elinor</creatorcontrib><creatorcontrib>Rudders, Susan A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brown, Julie C.</au><au>Simons, Elinor</au><au>Rudders, Susan A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epinephrine in the Management of Anaphylaxis</atitle><jtitle>The journal of allergy and clinical immunology in practice (Cambridge, MA)</jtitle><addtitle>J Allergy Clin Immunol Pract</addtitle><date>2020-04</date><risdate>2020</risdate><volume>8</volume><issue>4</issue><spage>1186</spage><epage>1195</epage><pages>1186-1195</pages><issn>2213-2198</issn><eissn>2213-2201</eissn><abstract>Epinephrine is life-saving and the only first-line medication in the management of anaphylaxis. At therapeutic doses, it acts rapidly to reverse nearly all symptoms of anaphylaxis, and stabilize mast cells. The standard approved doses administered intramuscularly in the lateral thigh have a long track record for safe and effective use, but more information is needed on epinephrine pharmacokinetics and pharmacodynamics to ensure that current dosing strategies are optimal. Epinephrine should be administered promptly once anaphylaxis is suspected, to minimize morbidity and mortality. Providers on the front-line for managing patients with life-threatening allergic reactions need clear parameters and tools to guide the appropriate use of epinephrine, which take into account the potential evolution of symptoms and signs over time. All patients at risk for anaphylaxis should carry 2 epinephrine autoinjectors and be taught and able to demonstrate how to use them. Epinephrine autoinjectors need to be affordable, readily available, and easy for patients with allergies to carry and use. 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subjects | Adult Adults Allergies Anaphylaxis Anaphylaxis - drug therapy Autoinjector Auvi-Q Benefit Cost Delivery Disease control Dosage Dose Edema Emerade Emergency medical care Epinephrine Epinephrine - therapeutic use EpiPen Generic Histamine Humans Hypotension Infant Infants Injections Injections, Intramuscular Length Management Mast Cells Morbidity Needle Patients Pharmacodynamics Pharmacokinetics Teva |
title | Epinephrine in the Management of Anaphylaxis |
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