Difference between Epipen and Epipen Jr

Anaphylaxis and/or anaphylactic shock is a potentially serious and life-threatening emergency that is caused by a severe allergic reaction. Properly understanding this allergic reaction and the difference between epipen and epipen jr is important.

 

This allergic reaction can come on suddenly and quickly due to a variety of causes or triggers such as insect stings (Bees, Hornets, Wasps, Ants, etc.), allergy injections, foods, and medicines (Example: Penicillin and its derivatives).

 

Symptoms of this reaction include low blood pressure or hypo-tension, reactions of the skin such as hives or itching, trouble breathing, wheezing, weak pulse, nausea, vomiting, diarrhea, dizziness, and fainting.

 
 

According to the Mayo Clinic, you have a higher proclivity or susceptibility for anaphylaxis if you had previous anaphylaxis, a condition of asthma or allergies, or other conditions such as heart disease or a buildup of specific types of white blood cells leading to mastocytosis. 

 

If you exhibit the risk factors leading to a higher proclivity toward anaphylaxis, it is often recommended by medical professionals to carry epinephrine as a defensive measure against this type of reaction. 

 

The epinephrine is a medication given by injection through the use of a special automatic injector device that is convenient for use. 

 

 

This special automatic injector device is called an EpiPen for adults and EpiPen Jr. for children. 

 

When used properly, this device injects an appropriate dose of epinephrine that allows for an individual to have more time in getting medical assistance. 

 

The epinephrine content inside of an EpiPen or EpiPen Jr device works on both alpha-adrenergic and beta-adrenergic receptors that are located throughout the body.

 

The action on the receptors help to keep the blood pressure from lowering too much and relaxes the lung muscles for better breathability. It also aids in itching, rashes, hives, and other symptoms associated with an allergic reaction. 

 

The EpiPen should be used in adults and/or children who weigh more than 30kg on the metric system or more than 66 lbs in relation to the imperial system. 

 

The EpiPen Jr should be used in children weighing 15-30kg on the metric system or 33-66 lbs on the imperial system. 

 

Remember, the metric system is more common in places like Europe for measurements while the imperial system is more common in places like the United States.

 

Why the weight distinction pertaining to the EpiPen vs EpiPen Jr? 

 

This is because the EpiPen Jr contains a different strength of epinephrine that injects a lower dose more suitable to those who are younger or smaller children. This epinephrine dose is 0.15mg.

 

In contrast, the EpiPen contains an epinephrine dose of 0.3mg. 

 
 

In a randomized double-blinded parallel-group pilot study, children at risk for anaphylaxis self-injected epinephrine using either an EpiPen Jr or an EpiPen with the oversight of a qualified physician.

 

The plasma epinephrine concentrations, blood pressure, heart rate, blood glucose, and adverse effects were monitored before and for 180 minutes after the injection.

 

The results indicated that a mean systolic blood pressure post-injection by 30 minutes indicated a significantly higher level with the EpiPen versus the EpiPen Jr.

 

With EpiPen Jr injection, each child experienced transient pallor with some also experiencing tremor and anxiety. After injection with the Epipen, each child developed transient pallor, anxiety, tremor, and palpitations or other cardiovascular effects; some also experiencing nausea and a developed headache.

 

The conclusion of the study informed that the injection with EpiPen versus the EpiPen Jr raised the systolic blood pressure exponentially but also caused more adverse effects. 

 

It is important when using either an EpiPen or EpiPen Jr to follow the instructions from your medical provider in an appropriate fashion. Family members at home should be aware of the potential condition of anaphylaxis and able to fully understand how to administer each pen should the need arise for those prescribed the epinephrine.

 

According to Mayo Clinic, the medicine is to be injected into the outer thigh only. This medicine should not be injected into a vein, fingers, toes, hands, feet, or buttocks muscles. If this is done, there is a possible increase in chance of having serious side effects. 

 
 

The EpiPen and EpiPen Jr devices also come with a training auto-injector device. This device comes with separate training instructions for use.

 

It is important to practice using the auto-injector training device before an emergency reaction takes place that induces anaphylaxis.

 

The auto-injector training devices are usually grey or beige in color. It is a good idea to keep the auto-injector training device separate from the primary EpiPen or EpiPen Jr devices to avoid accidentally grabbing the training device in the event of an emergency reaction. 

 
 

According to the Mayo Clinic, it is important to inspect the EpiPen or Epipen Jr devices from time to time in order to ensure that the blue safety release is not raised and that the device(s) can be easily removed from their carrier tubes. 

 

According to the Joint Task Force on Practice Parameters guidelines, it is often recommended for patients with risk factors toward anaphylaxis to carry two epinephrine devices at all times.

 

There is a likelihood that a second dose may be needed to help combat the emergency reaction. 

 

Remember, always seek medical attention as soon as possible when experiencing symptoms of anaphylaxis. Upon administration of a dose or two of epinephrine through the use of an EpiPen or EpiPen Jr, it is very important to get medical assistance immediately should further complications arise.

 

This should be the case even if the symptoms improve drastically upon administration of a dose or two of epinephrine. 

 

Sources
https://pubmed.ncbi.nlm.nih.gov/11799385/
https://www.med.umich.edu/1libr/Pharmacy/EpipenAndEpipenJr.pdf
https://www.mayoclinic.org/drugs-supplements/epinephrine-injection-route/proper-use/drg-20072429
https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468
https://pubmed.ncbi.nlm.nih.gov/1576461/
https://safemedicationuse.ca/newsletter/downloads/201403NewsletterV5N2EpiPenJr.pdf
https://www.goodrx.com/epinephrine-epipen/what-is
https://allergylosangeles.com/allergy-blog/are-two-epipens-really-necessary/
 
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