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Epinephrine deliver...
Epinephrine delivery via EpiPen® Auto-Injector or manual syringe across participants with a wide range of skin-to-muscle distances
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- Worm, Margitta (författare)
- Charite, Div Allergy & Immunol, Dept Dermatol & Allergy, Berlin, Germany.
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- Nguyen, DucTung (författare)
- Meda Pharma GmbH & Co KG, Bad Homburg, Germany.
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- Rackley, Russ (författare)
- Mylan Inc, Canonsburg, CA USA.
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- Muraro, Antonella (författare)
- Padua Univ Hosp, Dept Woman & Child Hlth, Food Allergy Referral Ctr, Padua, Italy.
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- Du Toit, George (författare)
- Guys & St Thomas Hosp, Childrens Allergy Serv, Evelina London, London, England.;Kings Coll London, Fac Life Sci & Med, Sch Life Course Sci, Dept Women & Childrens Hlth,Pediat Allergy, London, England.;MRC & Asthma UK Ctr Allerg Mech Asthma, London, England.
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- Lawrence, Tracey (författare)
- Mylan Inc, Canonsburg, CA USA.
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- Li, Hong (författare)
- Mylan Inc, Canonsburg, CA USA.
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- Brumbaugh, Kurt (författare)
- Mylan Inc, Canonsburg, CA USA.
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- Wickman, Magnus (författare)
- Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)
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Charite, Div Allergy & Immunol, Dept Dermatol & Allergy, Berlin, Germany Meda Pharma GmbH & Co KG, Bad Homburg, Germany. (creator_code:org_t)
- 2020-06-10
- 2020
- Engelska.
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Ingår i: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 10:1
- Relaterad länk:
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https://uu.diva-port... (primary) (Raw object)
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https://ctajournal.b...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BackgroundIntramuscular (IM) injection of epinephrine (adrenaline) at the mid-anterolateral (AL) thigh is the international standard therapy for acute anaphylaxis. Concerns exist regarding implications of epinephrine auto-injector needles not penetrating the muscle in patients with greater skin-to-muscle-distances (STMD).MethodsThis open-label, randomized, crossover study investigated pharmacokinetics and pharmacodynamics following injection of epinephrine in healthy volunteers. Individuals were stratified by maximally compressed STMD (low, < 15 mm; moderate, 15–20 mm; high, > 20 mm). Participants received epinephrine injections via EpiPen® Auto-Injector (EpiPen; 0.3 mg/0.3 mL) or IM syringe (0.3 mg/0.3 mL) at mid-AL thigh or received saline by IM syringe in a randomized order. Eligible participants received a fourth treatment (EpiPen [0.3 mg/0.3 mL] at distal-AL thigh). Model-independent pharmacokinetic parameters and pharmacodynamics were assessed.ResultsThere were numerical trends toward higher peak epinephrine concentrations (0.52 vs 0.35 ng/mL; geometric mean ratio, 1.40; 90% CI 117.6–164.6%) and more rapid exposure (time to peak concentration, 20 vs 50 min) for EpiPen vs IM syringe at mid-AL thigh across STMD groups. Absorption was faster over the first 30 min for EpiPen vs IM syringe (partial area under curve [AUC] over first 30 min: geometric mean ratio, 2.13; 90% CI 159.0–285.0%). Overall exposure based on AUC to the last measurable concentration was similar for EpiPen vs IM syringe (geometric mean ratio, 1.13; 90% CI 98.8–129.8%). Epinephrine pharmacokinetics after EpiPen injection were similar across STMD groups. Treatments were well tolerated.ConclusionsEpinephrine delivery via EpiPen resulted in greater early systemic exposure to epinephrine vs IM syringe as assessed by epinephrine plasma levels. Delivery via EpiPen was consistent across participants with a wide range of STMD, even when the needle may not have penetrated the muscle.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Epinephrine
- Adrenaline
- Auto-injectors
- Obesity
- Body mass index
- Intramuscular injections
- Pharmacokinetics
- Anaphylaxis
- Skin-to-muscle distance
- Needle length
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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