Epinephrine absorption in children with a history of anaphylaxis☆,☆☆,★,★★
Section snippets
METHODS
We tested this hypothesis in a randomized, single-blind, single-dose, parallel-group pilot study in 17 children who received either a subcutaneous injection of 0.01 ml/kg epinephrine hydrochloride solution (maximum, 0.3 ml [0.3 mg]) or an intramuscular injection of 0.3 ml (0.3 mg) with the EpiPen Auto-Injector (Allerex Laboratory, Ltd., Kanata, Ontario, Canada).
The study was approved by the University of Manitoba Faculty Committee on the Use of Human Subjects in Research. Before entry into the
RESULTS
All the children participating in this study had a history of systemic anaphylaxis. Each child had an EpiPen available “around-the-clock” in case inadvertent contact with the allergen to which he or she was sensitive triggered another episode of anaphylaxis. The demographics of the two groups of children were similar (Table I).
Empty Cell Epinephrine solution (subcutaneous) EpiPen Auto-injector (intramuscular) No. of children in group 9 8 Age (mean ± SEM [range]) 8 ± 1 yr (4-12) 8 ± 1 yr (7-11)
DISCUSSION
The epinephrine doses and routes of administration selected for testing were based on current published recommendations.3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Ideally, the study would have been conducted in children during an actual episode of systemic anaphylaxis. As frequent timed blood samples are extremely difficult to obtain prospectively during a medical emergency when all efforts are focused on preservation of life, we opted instead to conduct it in highly allergic children at risk for
Acknowledgements
We thank Mrs. Diane Dilay, RN, and Mrs. Cathy Gillespie, RN, for their expertise.
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Cited by (0)
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From athe Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, Faculty of Medicine and bthe Division of Pharmaceutical Sciences, Faculty of Pharmacy, University of Manitoba, Winnipeg.
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Supported by the Children's Hospital Research Foundation.
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Reprint requests: F. Estelle R. Simons, MD, FRCPC, Children's Hospital of Winnipeg, 820 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1R9.
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