Summer 2002, Vol 8, No. 2

Ask The Expert: How Do I Protect Myself In Case of a Severe Allergic Reaction?

The following Article origionally appeared in The ALERT, Summer 2002, Vol 8, No. 2

You know that education, awareness and communication regarding latex allergy are all critical to avoiding exposure to latex and preventing allergic reactions. Despite your best efforts, however, exposure to latex may occur and with it the risk of anaphylaxis – a severe and potentially fatal allergic reaction. Therefore, it is essential that latex-allergic individuals be prepared to identify the signs and symptoms of anaphylaxis and take immediate steps to halt the reaction.

Because it is impossible to predict which allergic individuals will suffer an anaphylactic reaction, even those who have experienced a mild allergic reaction to latex should be equipped with an EpiPen® epinephrine auto-injector, the first-line standard of care for anaphylaxis that occurs outside the hospital setting. Administering epinephrine at the outset of anaphylaxis does not replace professional medical attention, but it does buy time for anaphylaxis sufferers to reach the emergency room for further care.

Identifying anaphylaxis
In contrast to local reactions such as dermatitis, anaphylaxis is a systemic allergic reaction that can kill within minutes, either through swelling that closes airways or through a fatal drop in blood pressure. The most common symptoms include hives; swelling of the lips, throat or tongue; and difficulty breathing or swallowing.

Other symptoms include a metallic taste or itching in the mouth; generalized flushing, itching or redness of the skin; abdominal cramps, nausea, vomiting or diarrhea; increased heart rate; plunging blood pressure (and accompanying paleness); a sudden feeling of weakness; anxiety or an overwhelming sense of doom; collapse and unconsciousness.

Once anaphylaxis begins, the treatment of choice is an immediate injection of epinephrine. Epinephrine – sometimes called adrenaline -- rapidly constricts blood vessels, relaxes the muscles in the lungs, reverses swelling and stimulates heartbeat, thereby reversing the most dangerous effects of an anaphylactic reaction. However, it does not replace medical help. The amount of epinephrine in an auto-injector is generally effective for only about 20 minutes and must be followed by emergency medical attention. Immediate follow-up care by medical professionals will provide the patient the full treatment necessary to counter an anaphylactic episode.

Arming yourself with an EpiPen
According to the American Academy of Allergy, Asthma and Immunology, people who have experienced symptoms of anaphylaxis previously are at risk for subsequent reactions and should consult their doctors about carrying an epinephrine auto-injector and administering it at the first sign of an allergic reaction. If you are allergic to latex, the easiest way to do this is to ask your doctor about a prescription for an EpiPen epinephrine auto-injector. EpiPen is a pre-measured dose of epinephrine for self-administration that is simple to use and is conveniently carried in a pocket or purse. Moreover, it is safe for latex-allergic patients because, unlike many syringes or IV tubes, EpiPen contains no latex.

EpiPen is available only by prescription, and your physician should be able to show you how and when to use it. EpiPen trainers (“dummy” units that do not contain epinephrine) are also available for practice. For animated step-by-step directions on how to administer EpiPen, you may consult the web site www.epipen.com.

EpiPen auto-injectors are available as a single unit and as EpiPen 2-Pak™. The EpiPen 2-Pak contains two active units and one trainer. Carry EpiPen with you at all times. It is also a good idea to keep units available in various locations. For example, you may want to keep one at work and another at home so that you are prepared no matter where you experience a severe reaction. Also, if you experience an especially severe reaction or are more than 15 minutes away from medical care, you may need more than one dose to manage your symptoms effectively. You may wish to plan for such contingencies by keeping two or more EpiPen units on hand just in case.

EpiPen auto-injectors are available in two dosages: EpiPen, 0.3 mg epinephrine for people weighing more than 66 pounds and EpiPen Jr,® 0.15 mg epinephrine for children weighing between 33 and 66 pounds.

Side effects of epinephrine may include palpitations, tachycardia, nausea, and respiratory difficulty. Epinephrine is ordinarily administered with extreme caution to patients who have heart disease.

Some tips on handling your EpiPen
EpiPen auto-injectors are designed to treat a single anaphylactic episode and should be discarded properly after use. You should also be careful not to expose EpiPen to direct sunlight or store it in places subject to extreme temperatures (such as a refrigerator or the glove compartment of a car). Exposure to heat and light can cause epinephrine to degrade, shortening the usable life of the product. And prolonged exposure to cold can cause EpiPen units to not work. They should be stored at room temperature.

Finally, you will need to replace your EpiPen at the time of its expiration date to ensure the unit is current.

The risk of anaphylaxis associated with latex allergy is a frightening reality, but if you are prepared to identify the symptoms and respond immediately with an EpiPen, you can greatly increase your chance of surviving a potentially dangerous situation.