Epipen use question

Posted on: Tue, 03/18/2008 - 4:54pm
dunc's picture
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Joined: 03/15/2008 - 21:35

I have never known exactly what to do, which is probably really bad, but it's better to know now than never.

1) If I know eat a nut, do I use the epipen right away or wait until I go into anaphylactic shock?
2) What if I just think I ate a nut but I'm not sure?
3) What would happen if I used the epipen when I didn't need it?

Posted on: Wed, 03/19/2008 - 12:45am
Netmug's picture
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Joined: 03/19/2008 - 07:38

If you know for sure that you had a nut, and you also know that eating a net inevitably means you will have a bad reaction, then using the Epi-Pen is wise. I would not wait for the symptoms before using it.
Using an Epi-Pen without having a reaction isnt the worst thing you can do. Basically, when secreted into the bloodstream, it rapidly prepares the body for action in emergency situations. The hormone boosts the supply of oxygen and glucose to the brain and muscles, while suppressing other non-emergency bodily processes (digestion in particular).
It increases heart rate and stroke volume, dilates the pupils, and constricts arterioles in the skin and gut while dilating arterioles in skeletal muscles. It elevates the blood sugar level by increasing catalysis of glycogen to glucose in the liver, and at the same time begins the breakdown of lipids in fat cells. Like some other stress hormones, epinephrine has a suppressive effect on the immune system.
Although epinephrine does not have any psychoactive effects, stress or arousal also releases norepinephrine in the brain. Norepinephrine has similar actions in the body, but is also psychoactive.
The type of action in various cell types depends on their expression of adrenergic receptors.

Posted on: Wed, 03/19/2008 - 1:21pm
TJuliebeth's picture
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Joined: 03/30/2005 - 09:00

If I knew my DD had eaten a peanut, I'd give her the Epipen. She has had one anaphalactic reaction and I wouldn't want to wait and chance another one.
I also carry Benedryl, I give her that if she has a mild reaction to something unknown(which may be from feathers, smoke, ect...) Of course, if she had hives or said her throat felt funny, I'd give her the Epi immediately...

Posted on: Wed, 03/19/2008 - 1:42pm
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

Your allergist should have given you a detailed emergency plan that covers this. If he/she didn't get a 2nd opinion allergist or call your existing one and insist on getting an emergency plan.
For some people plans say, 'if known or suspected ingestion wait for these signs (the signs of ana) and then give epi, other meds, call 911.' Other plans, esp for those who have had very severe reactions in the past such as those involving breathing issues or blood pressure drops, etc have plans that say to give the epi instead of waiting to see if there are signs of ana.
It is far better to use the epi when you don't need it than vice versa. The epi is not going to harm almost anyone with the exception of a small # of people with heart conditions. However, delayed giving the epi (beyond 20-30 min after the start of symptoms) = the #1 factor in causing FA fatalities. or vice versa--giving the epi within 20-30 min of symptoms in the case of an ana reaction = the #1 factor in surviving ana. Best wishes!

Posted on: Thu, 03/20/2008 - 12:57am
williamsmummy's picture
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Joined: 03/26/2002 - 09:00

Its quite easy to be prescribed an epi pen and never be taught how to use it!!
or simply that your parents havent explained things clearly or often enough. Practice helps!
I dont know if you are a adult onset allergic person , or a young adult just stepping out in to the world.
However what i can say is this,
that the symptoms you need to look out for are the internal ones.
if you feel dizzy, faint, or have difficulty swallowing, or talking. Or have a sudden asthma attack. (Esp if you may have eaten something that you think might contain some of your allergen in.)YOU NEED TO USE YOUR EPI PEN>
if you are feel that in any way that your life is in danger, USE YOUR EPI>
Things that make a reaction faster , and more severe,
drink
booze makes food be absorbed quicker, so is a increased risk, it also clouds judgement, so you may make different food choices, than you would if sober.
periods, or any hormonal upheaval.
exercise.
uncontrolled asthma. ( this plays a big factor in your reactions to an allergen)
any other illness, viral infections etc.
To gain confidance with your epi pens, try and get a 'trainer' pen from the manufactuers. read the leaflet inside your epi pens.
When your epi pens are out of date, get new ones, and then use the out of date ones for practice.
use the epis on a grapefruit or large orange.
Its the practice that helps us all gain confidance with our families allergies. You are not the only person with epi pens to feel this way. so dont worry, you will gain confidance in time.
hope this helps

Posted on: Thu, 03/20/2008 - 3:04am
kandebuttahfly's picture
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Joined: 12/27/2007 - 17:08

williamsmummy - you said get new ones when they expire... do you use the date on the actual epi, or do you go by what the RX label says (a year after its filled), my dates are off by several months, just wondering which everyone goes by!

Posted on: Thu, 03/20/2008 - 5:39am
gw_mom3's picture
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Joined: 02/14/2000 - 09:00

We go by the date on the pens.

Posted on: Thu, 03/20/2008 - 7:45am
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

Originally Posted By: williamsmummyIts quite easy to be prescribed an epi pen and never be taught how to use it!!
or simply that your parents havent explained things clearly or often enough. Practice helps!
I dont know if you are a adult onset allergic person , or a young adult just stepping out in to the world.
However what i can say is this,
that the symptoms you need to look out for are the internal ones.
if you feel dizzy, faint, or have difficulty swallowing, or talking. Or have a sudden asthma attack. (Esp if you may have eaten something that you think might contain some of your allergen in.)YOU NEED TO USE YOUR EPI PEN>
if you are feel that in any way that your life is in danger, USE YOUR EPI>
Things that make a reaction faster , and more severe,
drink
booze makes food be absorbed quicker, so is a increased risk, it also clouds judgement, so you may make different food choices, than you would if sober.
periods, or any hormonal upheaval.
exercise.
uncontrolled asthma. ( this plays a big factor in your reactions to an allergen)
any other illness, viral infections etc.
To gain confidance with your epi pens, try and get a 'trainer' pen from the manufactuers. read the leaflet inside your epi pens.
When your epi pens are out of date, get new ones, and then use the out of date ones for practice.
use the epis on a grapefruit or large orange.
Its the practice that helps us all gain confidance with our families allergies. You are not the only person with epi pens to feel this way. so dont worry, you will gain confidance in time.
hope this helps
You brought up a lot of good points.
My son's emergency plan calls for giving the epi for many other situations as well. Every plan is different and I think it is important to get an emergency plan from a good board certified allergist.

Posted on: Thu, 03/20/2008 - 9:34am
williamsmummy's picture
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Joined: 03/26/2002 - 09:00

the date on the epi pen is the true date. when you get a new epi pen , it should have a yr to 18 month shelf life.
check your epi pens,
check that the adrenaline is clear, any yellowing or straw coloured liquid shows deteriation, and it should be replaced, regardless of epi pen date.
However ,if you have a reaction , use it, it may help, it will not be at full strength, but it will be useful.
This also applies to out of date epi pens.
NEVER use old epi pens for training practice until you have new ones in hand. It sounds silly, but this does happen.
Carry two epi pens at all time.
In the haze of using an epi pen, you might forget something , so having two will be required.
Epi pens must not be exposed to extreme temps, no leaving in cars in hot weather, or overnight in the cold.
No hot beaches either! (use a cool bag)
when skiing, use plastic bubble wrap and put them inside jacket pocket.
This does not effect the adrenaline, but effects the fireing mechanism ( sorry about spelling, its late here in the UK!)
When i mentioned the car, I have to point out that leaving epi pens in cars full stop is a bad idea. Plenty of people have ran or walked to cars when reacting and this speeds up a reaction.
If you are thinking of your emergency meds routine, it should go something along the lines of this,
1. have epi pens with you. ( if you dont, send someone to fetch them)
2) sit down on floor.
If you get dizzy ( a sign of lowering blood pressure , you dont want to fall of a chair, you are safer on the floor and can move in to a better recovery posisiton.
3)if you are not having any asthma, lay down.
Ask someone to raise or hold your feet.
4) if you are having asthma, sit up.
dont be afraid to ask for someone to support you.
5) dont go to the bathroom ON YOUR OWN!
However whats really important is this,
TAKE YOUR EMERGANCY MEDICATION !!!( in to your middle upper outer thigh. NOt through the seams of jeans or the pockets on combat trousers. It has to be in the middle , upper , outer thigh. ( got that?!!)
GET SOME ONE TO CALL FOR HELP TO GET YOU TO THE HOSPTIAL>
Stay in hospital for 4 hours if possible to be observed, in case of a later reaction. ( this is called bi-phasic)
DONT LEAVE HOSPITAL WITHOUT REPLACEMENT EPI PENS>
When you practice with your trainer , go through the whole routine, get your body in to postition , or get a friend to play you, move them in to possitions and give them the epi pen.
hope this helps.

Posted on: Fri, 03/21/2008 - 11:12am
Kanji's picture
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Joined: 01/30/2008 - 16:26

Hi WilliamsMummy,
Nicely put. I've had a child with FA for 3 years now, and I've only just worked out the part about blood pressure/laying down but only if no breathing problems.
You'd think (!!!) doctors, or FAAN or other organizations would have an emergency plan that included vital information like that.
Also very important to have a replacement epi before leaving hospital - what a great idea. I've never thought of it before, or heard it elsewhere.
Thanks for your very informed posting!

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