Transcript Document

Guildford and Waverley CCG
Medicines Management - update
on adrenaline autoinjectors
24th July 2014
Prescribing Clinical Network
Adrenaline autoinjectors were discussed at the meeting in May
2014
• The PCN supports the prescribing of Jext®, EpiPen® or
Emerade® as treatment options for patients requiring an
adrenaline auto injector.
• All patients should receive training on a regular basis to
ensure they know how to use their device (this could be done
by practice nurse or community pharmacist).
• Jext®, EpiPen® or Emerade® are considered as GREEN on the
traffic light system
Key Considerations
• The potential for supply shortages if choice is restricted to a single
device.
• Resuscitation Council UK guidelines on the Emergency
Management of Anaphylactic Reactions 2010 (These guidelines,
written for HCP treatment of anaphylaxis rather than emergency
self-administration of adrenaline by a patient or carer, recommend
the use of a 500mcg dose)
• The importance of prescribing by brand and maintaining on one
brand where possible for individuals
• The importance of training for both the HCPs and patients/carers
MHRA
• Drug Safety Update – May 2014
Summary
People who have been prescribed an adrenaline auto-injector
because of the risk of anaphylaxis should carry two with them at
all times for emergency, on-the-spot use. After every use of an
adrenaline auto-injector, an ambulance should be called (even if
symptoms are improving), the individual should lie down with
their legs raised and, if at all possible, should not be left alone.
MHRA
Adrenaline auto-injectors: a review of clinical and quality considerations –
reported June 2014
MHRA has conducted a review of all adrenaline auto-injectors approved in
the UK. This was in response to the death of an individual who had used an
adrenaline auto-injector during an anaphylactic reaction.
The recommendations include:
• updating people with allergies, their carers, and healthcare professionals
on the correct use of adrenaline auto-injectors
• informing people with allergies, their carers, and healthcare professionals
of measures to take to ease the symptoms of an anaphylactic reaction
while awaiting emergency medical help
• requiring manufacturers to provide data on whether the adrenaline from
an auto-injector is delivered into the muscle or fatty tissue
• requesting manufacturers to provide further technical information with
the aim of improving the performance of adrenaline auto-injectors.
Epi-Pen
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£26.45 for both 0.15mg and 0.3mg strengths
Swing and Jab method of admin
Shelf life – 18 months
The appropriate dosage may be 0.15mg (EpiPen Jr.) for children 1530kg body weight and 0.3mg (EpiPen) adrenaline for children >30kg
body weight,
• Storage conditions – do not store above 25ᵒC and do not refrigerate
or freeze.
• MEDA Pharmaceuticals Ltd - Tel: Jessika Housiaux 07795657974
www.epipen.co.uk
• To watch an animated video of how to use an Epi-pen go to
www.epipen.co.uk
Jext
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£23.99 for both 0.15mg and 0.3mg strengths
Shelf life – 18 months
Place and press method of admin
Available as:
Jext 0.3mg (licensed for 30kg+)
Jext 0.15mg (licensed for 15kg-30kg)
• ALK-Abello UK
• www.jext.co.uk Tel: Duncan Fraser 07917 473038
• To watch a video on how to use Jext go to
www.youtube.com/watch?v=CjgbwmQy2r8
Emerade
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Cost
– 0.15mg - £26.94
– 0.3mg - £26.94
– 0.5mg - £28.74
• Shelf life 30 months
• Place and press method of admin
• Children between 15 kg and 30 kg - Emerade 0.150mg. Patients
over 30 kg - Emerade 0.3mg or Emerade 0.5mg.
•
iMed Systems Ltd.
www.emerade.com - Tel: Alan Stern 07946 475705
• To watch a video on use of
Emerade: http://www.emerade.com/instruction-video
Summary
• Currently in the UK there are 3 different adrenaline autoinjector devices
• THEY ARE NOT INTERCHANGEABLE
• Please prescribe adrenaline auto-injectors by brand e.g. Jext , Epipen,
Emerade
• ANY change in device needs specific training for the patient (and their
carers)
• All 3 brands of adrenaline autoinjector have been given equal status by
the Prescribing Clinical network (PCN)
• All 3 manufacturers of adrenaline autoinjectors provide:
– Expiry date reminders for patients that register
– Patient information / videos on how to administer
– Training and dummy pens for Healthcare Professionals
Prescribing Advisory Database “PAD”
•
Please visit the Prescribing Advisory Database "PAD" at its new website address
http://pad.res360.net/
•
Google – Prescribing Advisory database
•
Download App from the website