Understanding Anaphylaxis and Epinephrine
When a person has a severe allergic reaction, known as anaphylaxis, their immune system releases a flood of chemicals that can cause life-threatening symptoms. These symptoms include swelling of the throat and tongue, difficulty breathing, a sudden drop in blood pressure, hives, and dizziness. An epinephrine auto-injector is the first-line treatment for this emergency situation and is intended for immediate administration by the patient or a caregiver.
The medication inside, epinephrine, is a naturally occurring hormone (also called adrenaline) that works quickly to counteract these dangerous effects. It relaxes the muscles in the airways to improve breathing, tightens blood vessels to raise blood pressure, and helps stop the progression of the allergic reaction. Because anaphylaxis can worsen quickly, prompt administration is vital.
Common Anaphylaxis Triggers
Severe allergic reactions can be triggered by a variety of substances. The most common triggers that necessitate carrying an allergy pen include:
- Foods: Peanuts, tree nuts, shellfish, eggs, and milk are frequent culprits.
- Insect Stings: Bites or stings from bees, wasps, hornets, and fire ants can cause severe reactions in some people.
- Medications: Certain drugs, like penicillin, can trigger an allergic response.
- Latex: Exposure to latex in medical supplies or other products can be a trigger.
- Exercise: In some rare cases, physical activity can induce anaphylaxis.
How to Use an Epinephrine Auto-Injector
Different brands of auto-injectors have slightly different instructions, but they all follow a similar, simple process. It is crucial to be trained by a healthcare provider on how to use the specific device you or your loved one has been prescribed.
General steps for using most auto-injectors include:
- Remove the device from its carrying case and remove the safety cap. It is essential to never place your thumb over the end where the needle emerges.
- Press the tip of the injector firmly against the middle of the outer thigh at a 90-degree angle. The injection can be administered through clothing.
- Hold the device in place for the required amount of time, which varies by brand (often 3-10 seconds), until the injection is complete. A click is usually heard, signaling the start of the injection.
- Remove the auto-injector from the thigh. The needle will retract and be safely covered.
- Massage the injection site for several seconds to help the medication disperse.
- Immediately call 911 or seek emergency medical help. The medication is a temporary measure, and further medical treatment is necessary. Many reactions can recur, and a second dose may be needed.
Proper Storage and Expiration of Allergy Pens
Correct storage of epinephrine auto-injectors is crucial to ensure their efficacy during an emergency. The medication is sensitive to light and temperature extremes.
- Temperature: Store the device at room temperature, ideally between 68° and 77°F (20°-25°C). Avoid storing it in a car's glove box, which can experience extreme heat or cold.
- Light: The device should be protected from light and kept in its carrying case to prevent discoloration, which indicates a loss of potency.
- Expiration: Epinephrine auto-injectors typically have a shelf life of 12-18 months. It is vital to check the expiration date monthly and get a new prescription when it expires. While using an expired device is better than nothing, its potency may be reduced.
Comparison of Common Epinephrine Devices
Several devices are available on the market, each with unique features. Your doctor can help determine the best option for you or your child. The key features of some leading devices are compared in the table below.
| Feature | EpiPen® | Auvi-Q® | Symjepi™ | Neffy® Nasal Spray |
|---|---|---|---|---|
| Delivery Method | Spring-activated auto-injector | Retractable needle auto-injector with voice instructions | Prefilled syringe with manual injection | Needle-free nasal spray |
| Key Features | Standard two-step process, most well-known brand | Automatically retracts the needle after injection, audibly guides the user through the process | Manual injection, smaller and more compact than auto-injectors | Needle-free administration, can last longer (up to 30 months) |
| Primary Patient Groups | Adults and children based on weight | Available in three weight-based doses, including a lower dose for infants and toddlers | Adults and children based on weight | Approved for adults and children over 30 kg (about 66 lbs) |
| Storage Concerns | Protect from heat, cold, and light | Protect from heat, cold, and light | Protect from heat, cold, and light | More tolerant of temperature fluctuations, but do not freeze |
Important Considerations and Side Effects
While epinephrine auto-injectors are safe for most people in an emergency, they are a powerful medication. Common side effects can occur, which usually subside quickly. These include anxiety, restlessness, shakiness, headache, dizziness, and a rapid or pounding heartbeat.
Serious side effects are rare but can occur, especially in individuals with pre-existing conditions like heart disease, high blood pressure, or diabetes. These can include abnormal heart rhythms, a sharp increase in blood pressure, or even stroke or heart attack. For this reason, it is critical to use the device only when a severe allergic reaction is suspected and to seek immediate medical attention afterward.
It is also important to note that accidental injection into a finger, hand, or foot can cause a loss of blood flow to the affected area. If this happens, immediate medical attention is necessary.
Conclusion: Always Be Prepared
Knowing what are those allergy pens called and how to use them is a critical step in managing severe allergies. They are epinephrine auto-injectors, and having two doses readily available at all times can be a life-saving measure. With the availability of multiple device options, including the new needle-free nasal spray, patients have more choices than ever before. However, no matter the device, immediate medical follow-up is mandatory after using an epinephrine auto-injector.
By staying informed about your medication, practicing its use with a trainer, and keeping it stored correctly, you can face emergencies with greater confidence. For additional resources and training on epinephrine administration, consult your healthcare provider or visit the resources provided by the Food Allergy Research & Education (FARE) organization.
