EPI PEN

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can we use epi pen for asthma attack since its like the same with severe allergy that shuts the airway.. thanks

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Specializes in Family Practice, Urgent Care, Cardiac Ca.

A) Medical advice is outside of the terms of service,

B) I really hope no one is waiting on this answer...

C) This knowledge is public domain and may be accessed by reviewing indications for Epi-Pens: It is not exactly the same mechanism as allergies, and though it may be precipitated by some of the same iG pathways, it's not always. Giving epi to a person without a true anaphylactic reaction can cause harm... If they have asthma, there are better ways to treat it.

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Specializes in LTC, Acute Care.
can we use epi pen for asthma attack since its like the same with severe allergy that shuts the airway.. thanks

I have heard that you can, if the problem being medicated is actually an asthma attack but is mistaken for an anaphylactic reaction. However, I definitely wouldn't take an Epi-Pen for an asthma attack that I recognized as an asthma attack without anaphylaxis. I usually have some hours, sometimes days, of warning with my most severe asthma attacks eventually warranting something as drastic as what you are asking.

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Specializes in ICU, LTACH, Internal Medicine.

EpiPen MUST NOT be used for treating anything but anaphylaxis (Epi is my companion for the last 34 years, so we really got to know each other).

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Specializes in Education, FP, LNC, Forensics, ED, OB.

OP, why are you asking?

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I would only use it for asthma if the RX on the label indicated that it be used for that particular patient in that way.

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I think that would not be appropriate... better stick to what it's for...

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Specializes in Pediatrics, Psych.

Here's some helpful info I found on an Australian asthma ".org" webpage:

Asthma and allergies are closely linked so it can seem logical that treatments for one condition may help the other. The medication used to treat a severe allergic reaction (anaphylaxis) does have an effect on the airways, so it can be tempting to think that it would be a good, and perhaps faster, option in asthma. However it is not generally recommended that an adrenaline autoinjector like EpiPen is used in place of reliever medication to treat asthma symptoms. In a very small number of people with severe asthma, a specialist may recommend this, but it's very unusual, and it will always be written in as part of an Asthma Action Plan.

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Specializes in Complex pedi to LTC/SA & now a manager.

I think the issue is now solved since the original post is from 5 years ago. The only official indication for an epipen is emergent treatment of anaphylaxis.

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Specializes in Adult and Pediatric Vascular Access, Paramedic.

The answer isn't a yes or no. And Asthma is NOT the same reaction as an acute anaphylactic reaction!

The epi-pen was truly designed for lay people for the rapid administration of 1:1,000 Epinephrin 0.3 mg in the adult and 0.15 mg in the pediatric patient having an anaphylactic reaction. That being said Epi-Nephrine 1:1,000 can also used at the same dose for adults in the case of SEVERE asthma exacerbation and more frequently in pediatric patients for severe asthma exacerbation. You should keep in mind though with Magnessium Sulfate now being used more and more, Epi is not used frequently anymore.

So could you use it in a patent having a severe asthma attack? Yes, but only if you are a trained medical professional, and not a lay person. Here are some very important things to remember as well, as to why you are MUCH better off drawing 1:1,000 Epi from a vial for the asthma patient:

1) Epi auto injectors are VERY expensive, costing 100.00 or more! Compared to a vial of Epi which costs far less!

2) With asthma patients, you have more time to draw up Epi and have it ready while you wait to see if the other medications, like nebulized Albuterol and Atrovent, Magnessium, as well as CPAP, are going to work first. Epi is NOT a first line medication in asthma any longer if the person has a pulse.

3) Epinephrine should be a last resort in asthma patients, especially adults, since in an older adult it could result in cardiac related complications.

4) Magnesium Sulfate is safer and has been shown to be effective. This is now used, in most cases, instead of Epi.

5) Pediatric patients can vary greatly in size and weight, thus a junior auto injector (which only comes in one needle size and one dose) should not be used except in the case of anaphylaxis when emergent administration of Epinephrine could be life saving. A pediatric patient suffering from asthma or bronchiolitis needs a weight based dose of Epi, and again in most cases Magnessium will be used first (aside from nebulizer medication and steroids).

7) I am not sure if you have every given an auto injector to someone, but the needle on the adult is large and comes out with a lot of force, thus it is quite painful to the patient. Why cause unnecessary pain?

8) It can be difficult to tell if the appropriate does was delivered from the auto injector since some medication will remain in the pen whether you inject the right amount or not.

6) I have not seen Epi used for asthma exacerbation in a long time, I think it has fallen by the wayside especially in adult patients because of the dangers. It is still in my paramedic protocols, but it is way at the bottom of the list. Given that we now have CPAP on the ambulance, magnesium, all the nebulizers you could dream of, and steroids I have not seen the need to use it. I would be very hesitant to given Epi to an older adult, unless they are in cardiac arrest, or they are having an anaphylactic reaction. The risks outweigh the benefits!

I am not sure if you are a nurse or lay person, if you are a lay person you SHOULD NEVER give it for asthma, as you do not have the proper training or education to do so!

Annie

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Specializes in Pediatrics, Psych.

I am not sure if I totally agree with all of your points. While I completely agree that the indication for an Epi-Pen is anaphylaxis (and NOT an acute asthma attack), in a true emergency (i.e. someone's airway is closed), there is no absolute contraindication for administering a life saving drug (assuming you are not in a hospital with other treatment options or have EMS at your side)

This fool-proof auto-injector was CREATED specifically for LAY people with no medical background or knowledge of medicine or even physiological processes. During school Epi-Pen trainings, I review signs and symptoms of anaphylaxis. Teachers are always worried that they will not be able to differentiate between an asthma attack and an anaphylactic reaction. Remember, the bottom line: when in doubt, give the Epi-Pen without delay. A big concern is that too many lay people hesitate in giving the Epi-Pen, and anaphylaxis progresses to the point that one shot of .3 mg IM Epi is not effective. Also, Epi-pens are covered by the Good Samaritan Law

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