Anaphylaxis - Facts and Advice
Anaphylaxis is the most severe form of allergic reaction and is potentially life-threatening. It must be treated as a medical emergency.
Anaphylaxis occurs after exposure to an allergen (usually to foods, insect stings or medications) to which a person is already extremely sensitive.
It is characterised by acute respiratory and/or cardiovascular symptoms or signs and involvement of other systems such as the skin or gastrointestinal tract. Administration of adrenaline is the first-line emergency treatment for anaphylaxis.
Adrenaline auto-injectors contain a single dose of adrenaline designed for use by non-medical people.
Currently, two brands of adrenaline auto-injectors are available in Australia – Anapen and EpiPen. Both appear superficially similar, but have substantially different administration techniques.
• The Anapen auto-injector is triggered by depressing a red button with the thumb.
• The EpiPen device is held mid-section – with the thumb and fingers forming a fist – and triggered by pressing firmly into the outer mid-thigh.
All patients with a history of acute allergic anaphylaxis should have access to an adrenaline auto-injector.
A history of generalised allergic reaction and one or more risk factors below warrants consideration of anaphylaxis risk – refer or consult with an appropriate specialist.
Risk factors include:
• Asthma.
• Age (children over 5 years, adolescents and young adults).
• Specific allergic triggers such as peanut/nut allergy and/or stinging insect allergy.
• Comorbidity (e.g. ischaemic heart disease).
• Geographical remoteness from emergency medical care.
An adrenaline auto-injector should only be prescribed as part of a comprehensive anaphylaxis management plan.
Pharmacists can:
• Ensure patients at risk of anaphylaxis have an anaphylaxis management plan and an Action Plan from the GP/specialist.
• Encourage adrenaline auto-injector training with the patient and carer before dispensing. Advise patients and carers about adrenaline’s storage conditions and short shelf life, the need to check expiry dates, and to replace the auto-injector before the expiry date.
• Acknowledge non-PBS enquiries for institution’s first aid kits and provide product information and training on their choice of adrenaline auto-injector.
Useful URLs:
Australasian Society of Clinical Immunology and Allergy (ASCIA) www.allergy.org.au
Anaphylaxis Australia www.allergyfacts.org.au
National Prescribing Service (NPS) www.nps.org.au
References:
ASCIA: Anaphylaxis Resources www.allergy.org.au
NPS Radar: Adrenaline Auto-injector (Anapen) For Acute Allergic Anaphylaxis. www.npsradar.com.au.