Just when you thought you had your EpiPen anaphylaxis patient education down pat, out new to the market is a new adrenaline autoinjector The Anapen. The Anapen has a very similar profile to the Epipen, however it has a longer shelf life. The Anapen is administered differently to the EpiPen by depressing a red button with the thumb, whereas the Epipen device is held in the mid section-with the thumb and finger forming a fist -and triggered by pressing firmly into the outer mid thigh. Both the Anapen and EpiPen are listed on the PBS, however only one brand should be prescribe to avoid confusing in administration technique
What patients are at risk for severe or fatal anaphylaxis with a history of generalised allergic reaction?
All these patient should be prescribe an adrenaline autoinjector device, and educated in its use.
- Asthma (current or past history)
- Age (children over 5 years, adolescents and young adults)
- Specific allergy triggers
- Peanut/nut allergy
- Stinging insect allergy in adults (bees, wasps, jumper ants)
- Comorbidity (e.g. ischaemic heart disease)
- Geographical remoteness for emergency medical care.
What are the recommended adrenaline autoinjector doses?
| Weight | Adrenaline autoinjector (strength) |
|---|---|
| Children < 10 kg | Not usually recommended |
| Children 10–20 kg | Anapen Junior (150 micrograms) or EpiPen Jr (150 micrograms) |
| Adults or children > 20 kg | Anapen (300 micrograms) or EpiPen (300 micrograms) |
How should the anapen be administered?
Vs
Anapen summary
- Anapen has a substantially different administration technique to that of EpiPen. Specific training is required for each autoinjector.
- Ensure that all patients prescribed an adrenaline autoinjector have an anaphylaxis management plan that includes:
- Referral to appropriate specialist
- Identification of the relevant allergen(s)
- Education and avoiding allergens
- An anaphylaxis action plan
- Appropriate follow-up and review
- Train patients to recognise the symptoms of anaphylaxis and how to use their adrenaline autoinjector correctly
- Parents should advise preschools or schools of their child’s adrenaline autoinjector prescription, and provide a completed anaphylaxis action plan illustrating the device provided.
- Some high-risk patients can be prescribed two adrenaline autoinjectors, but they must be off the same brand.
- Advise patients to check the expiry date of their adrenaline autoinjector regularly.
References
- Anapen.com
- The Australian Society of Clinical Immunology and Allergy
- NPS RADAR (2010). Adrenaline autoinjector (Anapen) for acute allergic anaphylaxis. (full text)
About Kane Guthrie
