EpiPens have saved a significant number of lives over the last five decades. These devices can help open up the airways of a person experiencing an anaphylactic shock after an allergic reaction.
EpiPens are devices containing epinephrine, also known as adrenaline. They’re known as auto-injector devices because you can use them to inject yourself with the medication.
People can use an EpiPen when they experience a severe allergic reaction, called anaphylactic shock or anaphylaxis, to open up their airways and raise their blood pressure.
Doctors have used epinephrine for the last 50 years to save people’s lives. However, EpiPens only became available on the market for the public about 40 years ago.
When were they invented?
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After Jokichi Takamine discovered adrenaline and its effects between the end of the 19th and the beginning of the 20th century, scientists soon discovered how to create this hormone in a lab. They then start producing adrenaline kits to treat allergic reactions and a wide variety of other health conditions.
Scientists invented auto-injectors in the 1960s for a rapid self-administration of a dose of nerve gas antidote. In the mid-1970s, Sheldon Kaplan invented the first EpiPen containing epinephrine at Survival Technology in Bethesda, Maryland, United States.
Richard B. Toren also contributed to the development and design of the EpiPen. He had the idea of creating a portable device that could treat severe allergic reactions. This is because his daughter had an allergy to bees and the necessity to bring a complex treatment kit with her in case she got a bee sting.
On December 22, 1987, the Food and Drug Administration (FDA) approved the EpiPen as a treatment for anaphylaxis. EpiPens then became available to the public, helping to prevent numerous casualties linked to anaphylactic shocks.
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The first versions of the EpiPen raised several concerns about people accidentally injecting themselves or other people with epinephrine shots. This could lead to cardiovascular complications, even if the occurrence of adverse effects after receiving an epinephrine shot is rare.
Unintentional injuries, injections, and lacerations could occur with older EpiPens as they had exposed needles. Most cases of accidental injection occurred among caregivers and children.
Recently, a new design of EpiPen was released. The new design of the EpiPen auto-injector device has several features, including a needle sheath to prevent unwanted injections.
Other features of the new EpiPen include a label and an arrow stating which side the needle is to prevent thumb punctures. The new EpiPen also has a built-in needle that is never exposed before and after the injection.
The EpiPen also comes in two different colors to make it easier to distinguish the strength of the shot in each auto-injector. EpiPens that contain 0.15 milligrams (mg) are green-colored, while those containing 0.30 mg of epinephrine are yellow.
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Types of EpiPen
EpiPen comes in two different dosages. A yellow-colored pen contains 0.30 mg of epinephrine, which is suitable for adults and children who weigh 30 kilograms (kg) or more. A green-colored pen called EpiPen JR is available for treating children who weigh between 15 and 30 kg, containing 0.15 mg of epinephrine.
In 2018, the FDA approved the first generic version of the EpiPen made by Teva Pharmaceuticals.
Teva’s epinephrine auto-injectors come in two different dosages: 0.30 mg for adults and 0.15 mg for children. They have also maintained the same color code as EpiPen to help you quickly recognize the amount of epinephrine contained in the auto-injectors.
After using an epinephrine auto-injector in response to anaphylaxis, you must call the emergency services and seek medical attention.
People should always carry 2 epinephrine auto-injectors. They may need a second dose of adrenaline to treat anaphylaxis while they wait for the emergency services.
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Epinephrine is the first-line treatment for the initial phases of anaphylaxis. When the emergency services arrive, they will administer other medications to reduce the risk of further complications. These may include:
Intravenous (IV) fluids: Anaphylaxis can disrupt blood flow in some body parts. Giving IV fluids can restore the usual blood flow and stabilize blood pressure alongside epinephrine.
Corticosteroids: Medications such as methylprednisolone (Medrol) and hydrocortisone (Cortef) can help reduce the length of anaphylaxis. They may help open up the airways and prevent the recurrence of anaphylaxis after receiving the initial treatment.
Bronchodilators: Medications, such as albuterol (Proventil), can help open up the airways in people with breathing difficulties. They are beneficial for people with asthma experiencing anaphylaxis.
Vasopressors: Doctors may give these medications to people who have anaphylaxis and require multiple doses of epinephrine but experience side effects, such as arrhythmia or chest pain. Examples like midodrine (Orvaten) can help raise blood pressure and prevent a low blood pressure (hypotensive) shock.
Antihistamines: Doctors prescribe medications such as diphenhydramine (Benadryl), cetirizine (Zyrtec), or famotidine (Pepcid) to help with other anaphylaxis symptoms like itching and hives. But note that antihistamines do not help improve your breathing.
If you or anyone around you have any signs of anaphylaxis or you have used an EpiPen, contact the emergency services immediately.
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Summary
The EpiPen is an auto-injector of epinephrine, also known as adrenaline, that people have used since 1987 as a first-line treatment of anaphylaxis. EpiPen comes in a 0.15 milligrams (mg) dosage for children who weigh between 10 and 25 kilograms (kg) and in a 0.30 mg dosage for people who weigh over 25 kg.
People should always carry 2 EpiPens as, in some cases, one dose may not be sufficient for treating anaphylaxis. After using an epinephrine auto-injector, you must promptly contact the emergency services for additional treatment.
