CSACI position statement: transition recommendations on existing epinephrine autoinjectors

Allergy, Asthma & Clinical Immunology

Kyla Hildebrand¹  Lucy Dong Xuan Li²  Douglas Paul Mack³  Elissa M. Abrams⁴  Elana Lavine⁵ 

[1] Department of Paediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, BC, Canada;Department of Paediatrics, Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada;Department of Paediatrics, Paediatric Allergy, Asthma, and Immunology, McMaster University, Hamilton, ON, Canada;Halton Pediatric Allergy, Burlington, ON, Canada;Department of Paediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, MB, Canada;Department of Paediatrics, University of Toronto, Toronto, ON, Canada;Department of Paediatrics, Queen’s University, Kingston, ON, Canada;

关键词: Epinephrine;    Anaphylaxis;    CSACI position statement;    0.5 mg epinephrine autoinjector;   

DOI  :  10.1186/s13223-021-00634-2

来源: Springer

【 摘 要 】

Epinephrine is the first line treatment for anaphylaxis, an acute potentially life-threatening allergic reaction. It is typically administered intramuscularly in the anterolateral thigh at a dose of 0.01 mg/kg of 1:1000 (1 mg/ml) solution to a maximum initial dose of 0.5 mg. Currently in Canada, epinephrine autoinjectors (EAI) are available in three doses, 0.15 mg, 0.30 mg, and 0.50 mg. There are currently no published studies comparing 0.3 mg and 0.5 mg EAIs in the paediatric or adult populations to compare clinical effectiveness. However, as weight increases above 30 kg, the percentage of the recommended 0.01 mg/kg epinephrine dose from an existing 0.3 mg EAI decreases resulting in potential underdosing. As such, The Canadian Society of Allergy and Immunology (CSACI) recommends that for those who weigh ≥ 45 kg, physicians could consider prescribing the 0.50 mg EAI based on shared decision making with patients.

【 授权许可】

CC BY