Epinephrine auto-injectors in Canada: A review of available products and clinical proposals
DOI:
https://doi.org/10.58931/cait.2023.3359Abstract
Anaphylaxis is a severe reaction with significant associated morbidity and mortality that necessitates prompt on-demand management for patients. Epinephrine administered intramuscularly at a dose of 0.01 mg/kg of body weight, up to a maximum single dose of 0.5 mg at one time, is the first-line treatment for anaphylaxis. Epinephrine auto-injectors (EAIs) are devices designed to deliver a predetermined dose of epinephrine rapidly and reliably into the vastus lateralis muscle of the mid-anterolateral thigh for treatment of anaphylaxis. All commercially available auto-injectors in Canada are fixed-dose delivery systems, therefore titration of epinephrine dose based on patient weight is not possible.
In Canada, there are several manufacturers of EAIs, providing treating physicians and patients with a variety of options to treat anaphylaxis in the community. However, as these devices all contain the same medication, physicians may not realize that specific EAIs may be of greater utility in certain clinical circumstances. This scientific review aims to describe all currently available EAIs in Canada, with detailed discussion on the differences between products and the nuances of a patient-centred approach to prescription in a market filled with seemingly “one size fits all” devices.
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