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Flashcards in Pharm - Epi Pens Deck (13)
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1
Q

Describe a type 1 hypersensitivity reaction

A
  • immediate
  • IgE mediated
  • IgE abs formed after drug exposure occupy receptors on surface of mast cells/basophils. If drug encountered again, it binds IgE abs and causes release of vasoactive mediators which cause the sx
2
Q

common meds that cause type 1 rxns

A
  • beta lactams

- quinolones

3
Q

mechanism of action of epinephrine for a type 1 hypersensitivity reaction

A
  • Acts as α-1 receptors to mediate increased vasoconstriction, increased peripheral vascular resistance, and decreased mucosal edema.
  • Agonist effect at β-2 receptors result in bronchodilation and decreased mediator release from mast cells and basophils
4
Q

active drug in the EpiPen

A

…… epinephrine …… :)

5
Q

EpiPen concentration

A

0.3 mg per dose

6
Q

EpiPen dosage

A
  • Adult: autoinjectors with 0.3 mg/dose
  • Large/obese adults: have access to at least 2 doses
  • Children: 0.01 mg/kg, up to 0.3 mg
  • Small children: 0.15 mg dose for kids between 10-25kg and 0.3 mg dose for those >25kg
  • Infants/toddlers: 0.1mg available→for infants/toddlers 7.5-15kg
7
Q

ADRs associated w/ the use of epi autoinjectors

A
  • tremor, dizziness, palps, anxiety, restlessness, HA

- serious ADR: myocardial ischemia after injection

8
Q

Describe the correct use of an epinephrine autoinjector

A
  • grip pen firmly and remove safety cap
  • swing and push pen into middle of outer thigh at 90 degree angle
  • keep pen pressed firmly against thigh for 10 s
  • remove pen and massage injection area
  • after use: get emergency help; make sure 2nd dose is close; take an antihistamine
9
Q

indications for use of EpiPen

A
  • trouble breathing
  • tightness in the throat
  • lightheaded or think they might pass out
  • not responding as expected/has altered consciousness during allergic reaction
  • has food allergies and is vomiting repeatedly shortly after eating (esp if accompanied by flushing/hives)
  • coughing repeatedly during allergic reaction
  • previous anaphylaxis and develops widespread hives after suspected/known ingestion of an allergen
  • has definitely eaten a trigger food that previously caused severe anaphylaxis (can use before symptoms in this case)
10
Q

patient education for EpiPen use

A
  • IM injection is preferred
  • hold w/ closed fist
  • children may not hold still so hold their leg firmly in place and for 3 or more seconds after
  • stay with other people during reaction
11
Q

emergency department use of EpiPen

A
  • if alone, self administer EpiPen then call for help to be transported to nearest ED ASAP **important to educate pt that the use of the EpiPen isn’t what’s dangerous, rather the reaction itself
  • even if the ED is close and EMTs on the way, still admin Epi
  • if pt becomes light headed, lie down and elevate legs
  • pt should never be propped up during anaphylaxis (empty ventricle syndrome)
  • transport to ED in supine position
12
Q

pt education for replacement of of EpiPens

A
  • should replace annually
  • inform pt it’s better to use out-of-date pen than to use nothing
  • store in locations w/ neutral temps (heat is the worst on them)
13
Q

explain the FDAs decision to allow the use of EpiPens beyond expiration date

A
  • FDA says certain EpiPens made b/w April-Dec 2018 can be used for an additional 4 mos to help ease shortages
  • study showed devices as much as 4 yrs out of date still contained 84-88% of intended dose