Is Self-injectable Epinephrine Being Used by Children With Food Allergy?

Alvarez-Perea, Alberto; Aparicio, V Fuentes; Freitag, P; Infante, Sonsoles; Zapatero, L.; Zubeldía, J M; Baeza, M.L.

doi:10.18176/jiaci.0426

Cited by 15 publications

(20 citation statements)

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“…It should be noted that in our registry 7% of patients had successfully used AAI. A similar result was found in a recent study conducted in Spain [50], as well as in the European anaphylaxis registry [8,16,49], showing that anaphylaxis in the community remains undertreated. As anaphylaxis is an unpredictable and life-threatening reaction, prevention is fundamental.Early recognition of anaphylaxis signs, correct use of AAI, early intramuscular adrenaline at the ED,and urgent referral to an allergy specialistshould bepromoted.…”

Section: Discussionsupporting

confidence: 88%

“…AAIunderprescriptionbyphysiciansforanaphylaxistreatmentiswellknownworldwide [8,20 ,25,33,48,49].AAI should be prescribed,due to the risk of recurrences,and education on when and how to use the device should be provided [23,48], training with placebo devices, insisting on AAI efficacy and safety. In the present registry, recurrence of anaphylaxisoccurred in 41% of the patients, and 21% experienced three or more episodes of anaphylaxis.Previous publications regarding recurrence of anaphylaxis found similar results, with a cumulative incidence ranging from 26.5 to 54% [6,15,16,22].Underutilization of AAI by patients and caregivers is also known [8,16,49,50]. It should be noted that in our registry 7% of patients had successfully used AAI.…”

Section: Discussionsupporting

confidence: 82%

“…Nevertheless, there are absolute indications for prescription of AAI according to EAACI and WAO guidelines [4,23] including previous anaphylaxis triggered by food, latex, or aeroallergens such as animals or other unavoidable triggers, as well as exercise-induced anaphylaxis or idiopathic anaphylaxis. Regarding food allergy, which is the leading culprit in this registry, some patients should carry an AAI namely if concomitant unstable asthma, or previous reaction to only traces of food, specially hidden allergens like TNs, peanut, CM or egg [4,23,50]. AAIunderprescriptionbyphysiciansforanaphylaxistreatmentiswellknownworldwide [8,20 ,25,33,48,49].AAI should be prescribed,due to the risk of recurrences,and education on when and how to use the device should be provided [23,48], training with placebo devices, insisting on AAI efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Gáspár

Santos

Faria

et al. 2022

J Investig Allergol Clin Immunol

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Gáspár

Santos

Faria

et al. 2022

J Investig Allergol Clin Immunol

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“… 53 In many cases, patients with anaphylaxis, despite their life‐threatening disease, are reluctant to carry their epinephrine auto‐injectors or to use them. 54 mHealth has been proposed as a possible solution to these challenging clinical situations. 55 Reminder systems and gamification of the management, including digital and real‐life rewards, may seem like obvious choices.…”

Section: Ehealth For Patients and Patient Representativesmentioning

confidence: 99%

The applications of eHealth technologies in the management of asthma and allergic diseases

Alvarez-Perea

Dimov

Popescu

et al. 2021

Clinical & Translational All

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Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term ‘eHealth’ stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost‐effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as ‘big data’. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.

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“…Epinephrine is the primary drug used in the management of severe anaphylaxis. For patients with serious allergies, it is crucial to be able to deliver epinephrine in a fast and efficient way, such as with an autoinjector [ 1 ]. The use of epinephrine autoinjectors has increased dramatically over the last two decades.…”

Section: Introductionmentioning

confidence: 99%

Reversal of Digital Ischemia with Phentolamine After Accidental Epinephrine Injection

2020

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Patient: Female, 26-year-old Final Diagnosis: Digital ischemia secondary to accidental epinephrine injection Symptoms: Pain Medication: — Clinical Procedure: Local injection of phentolamine to reverse ischemia Specialty: Plastic Surgery Objective: Management of emergency care Background: Accidental finger-stick injuries have been reported with epinephrine autoinjectors, such as EpiPen and EpiPen Jr, and can result in necrosis and digital ischemia. However, long-term adverse effects are very rare. The treatment for accidental finger-stick injuries is controversial and includes intra-arterial injections of vasodilating agents, topical vasodilators, and supportive management as needed. Case Report: Here, we report a case of a 26-year-old pharmacist who injected herself accidentally with an EpiPen on the tip of her index finger. Warm water and nitroglycerine gel did not alleviate her symptoms. After three hours, phentolamine was injected around the necrotic area, and the skin normalized. Conclusions: All health professionals should be trained in how to handle epinephrine autoinjectors safely. Phentolamine may be efficacious in treating accidental finger-stick injuries from epinephrine autoinjectors.

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Is Self-injectable Epinephrine Being Used by Children With Food Allergy?

Cited by 15 publications

References 0 publications

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

Anaphylaxis: A Decade of a Nationwide Allergy Society Registry

The applications of eHealth technologies in the management of asthma and allergic diseases

Reversal of Digital Ischemia with Phentolamine After Accidental Epinephrine Injection

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