When do I use my Epipen is a question commonly asked among patients who have food allergies. During the past 20 years food allergy has dramatically increased with an increase risk for anaphylaxis. Anaphylaxis is defined as “a serious allergic reaction that is rapid in onset and may cause death.” Foods are on of the most common causes of anaphylaxis over medications and insect stings (i.e. bees). Anaphylaxis is inadequately treated most of the time because of inconsistent signs and symptoms, anaphylaxis can manifest differently in the same person. The first emergency medication indicated in anaphylaxis treatment is intramuscular epinephrine. The most common cause of death from food allergies is delayed epinephrine administration.
(Injectable epinephrine is made by several manufacturers, most people know Epipen. Other names are Adrenaclick, Symjepi, Auvi-Q).
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There are no contraindications to the use of epinephrine for a life-threatening allergic reaction. Epinephrine is so crucial that administration is recommended even with the suspicion of a food allergic reaction occurring. Fatalities occur when epinephrine use is delayed or omitted altogether. It can be hard to identify anaphylaxis at times, as our bodies secrete adrenalin naturally owing to stress. Many people treat themselves with antihistamines (benadryl, claritin, allegra, zyrtec), but they only help skin symptoms and not respiratory distress or shock. Skin symptoms included redness, hives, itching and swelling. Past studies have shown that children who suffered fatal anaphylaxis were due to delayed epinephrine administration.
Experts in the allergy field around the world unanimously agree that prompt administration of epinephrine is the first line treatment of anaphylaxis. Guidelines suggest that prompt administration at the first indication of anaphylaxis and even go as far as to suggest administering the medication when in doubt.
Currently there are 2 preset doses in North America. For any individual weighing more than 30 kg (66 lbs), the dose is 0.3 mg. Below that the 0.15 mg dose should be used.
If you have food or bee sting allergies, ask your allergy doctor for a prescription of injectable epinephrine. You can ask your allergist when is the appropriate time to use it if a reaction occurs.