Injectable Anaphylaxis Treatment

This service is not suitable for people who:

• Are under the age of 17

• Are requesting treatment for someone other than themselves 

• Have not had a prescription for an adrenaline pen before

• Have not had or used an adrenaline pen for some time

• Want to change to a different adrenaline pen

• Are not confident with the injection technique for your specific adrenaline pen 

• Do not know the signs and symptoms of a severe allergic attack

It is caused by the overwhelming reaction of the body’s immune system to a specific substance (allergen) that the body mistakenly thinks is attacking it. This reaction can begin seconds or minutes after being exposed to an allergen.

Here is some more information about anaphylaxis.

This usually begins unexpectedly and rapidly progresses.

The most common symptoms include very rapid onset of:

• Swelling of the lips, tongue and throat
• Generalised rash – usually itchy and raised (like hives)
• Wheeze (and difficulty breathing)
• Fainting or collapsing due to low blood pressure
• Rapid heartbeat

Anaphylaxis occurs when the body's immune system, or natural defence system, overreacts to a trigger allergen.

This is often something you are frequently allergic to, but this is not always the case.

The following are common anaphylactic triggers:

• Foods – nuts, eggs, fish

• Medication – antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) e.g. Aspirin

• Insect bites or stings – bees, wasps, ants

• General anaesthetic drugs

• Contrast agents (dyes) – used in medical tests or scans 

• Latex – rubber gloves, condoms

In as many as 1 in 4 cases of anaphylaxis, no trigger can be identified despite extensive testing. This is known as Idiopathic Anaphylaxis. 

Your injectable anaphylaxis pen  contains a drug called adrenaline. This should be given immediately if there is any concern that an anaphylactic reaction is starting. You should give this if you think you are having an anaphylactic reaction, even if you are not sure.

It is essential that you dial 999 or 112, stating ANAPHYLAXIS, if you suspect an anaphylactic reaction is happening to enable urgent medical assessment. 

This should be done even if an injectable anaphylaxis pen has been administered and the symptoms are settling.

In some cases, an additional dose of adrenaline will be needed, and a second injectable anaphylaxis pen   will be required:

• If the person does not respond to the initial dose after 5 minutes
• If symptoms start to return
• If there is a fault with the first pen

This is why it is advised that you always have access to 2 pre-filled adrenaline pens.

Pre-filled adrenaline pens are known as adrenaline auto injectors (AAI), meaning they can be used to self administer a dose of adrenaline.

Adrenaline is known as epinephrine in some countries.

During an anaphylactic reaction, the chemicals that are released cause very serious symptoms:

• Sudden drop in blood pressure
• Narrowing of the airways and swelling of the lips/ tongue which can lead to breathing difficulties

The adrenaline in the injectable pen acts rapidly to treat these potentially life threatening symptoms of anaphylaxis so your blood pressure returns to normal and you can breathe more easily.

It can also help to alleviate other symptoms such as rashes and itch.

It is most effective if given within the first few minutes of a severe allergic reaction.

Examples of side effects include:

• Rapid heart rate & palpitations
• High blood pressure
• Nausea & vomiting
• Sweating
• Dizziness, tremor
• Agitation & anxiety
• Headache
• Breathing difficulties

For a full list of the potential side effects, read the information leaflet that comes with your medication .

The risk profile for pre-filled adrenaline pens is very good, if used correctly.

It is important to be aware that there is no reason not to use an injectable anaphylaxis pen if someone is having an anaphylactic reaction.

Injectable anaphylaxis pens (or any AAIs) should be stored:

• In a cool, dark place at room temperature, between 15-25°C – DO NOT refrigerate, as temperatures below 15°C may harm the injector device
• In an insulated wallet if the person carrying the injector is outside for an extended period of time e.g. hiking
• In a safe place where they are easily accessible

People at risk of anaphylaxis follow the advice of their allergy specialist on when to carry injectable anaphylaxis pens.

You should replace your adrenaline pen if:

• The injector has passed, or is in the month of expiry 

• The solution has is discoloured 

• There are solid particles within the solution 

• There are any signs of damage or leakage 

You should dispose of the injector if you suspect any of the above.

Each branded product has patient resources with clear information on this, and you should review this regularly. Ensure friends, family and work colleagues are trained to use the device.

Remember, not all AAI devices are the same and specific training is required for each individual device.

• Adrenaline pen devices are single use devices and cannot be reused, even if some adrenaline remains inside the device.
• Regularly check your AAI devices  to ensure they are in date. (You can set a reminder on your phone). The shelf life of these devices is usually 12-18 months.
• Always keep an adrenaline pen on hand since you never know when you might need it!
• The most prevalent causes of death from severe allergies are not having the injector with you and waiting too long to use adrenaline during an allergic reaction.
• If you have asthma, you are at risk of a more severe reaction – ensure your asthma symptoms are well controlled.
• If you have any concerns, consult with your doctor. You can book an appointment online to see one of our Irish registered GPs.