Summary and simulation of reported adverse events from epinephrine autoinjectors and a review of the literature

Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis

“…Although potential epinephrine-related adverse events must be balanced in high-risk patients (ie, elderly patients with multiple comorbidities and patients with complex congenital heart disease, pulmonary hypertension, prior epinephrineassociated cardiomyopathy), there is no absolute contraindication to epinephrine use in the treatment of anaphylaxis. 61,156 Providers should be aware of the need to appropriately counsel patients when using epinephrine. It is important to discuss technique of administration and the need to appropriately restrain young children and infants to avoid inadvertent epinephrine needle injuries.…”

A primer on cost-effectiveness in the allergy clinic

“…6 This is evident in the modern managed care environment, where services are capitated, medications are put in to preference tiers, when preferred networks and facilities exist, and when many services require peer review and prior authorization, and certain managements must be tried first and documented to fail. [64][65][66][67][68] The CEA will continue to play a significant role in medical decision making, and cost-effectiveness is a consideration when translating evidence to recommendations in the GRADE framework of international guideline development (Table 2). 26,43 However, although patient preferences and costs are considerations in all treatment decisions, consideration of economic tradeoffs presents unique challenges.…”

Got a Pen for Allergen Immunotherapy? Lessons from Near-Fatal Anaphylaxis with Pulmonary Edema

“…While adverse cardiovascular events in adults have been described infrequently, particularly after intravenous administration, only very rare individual cases of myocardial ischemia have been reported in children. 24,25 All institutions agreed that implementation of EIAs instead of drawn-up and manually injected epinephrine would reduce barriers to epinephrine administration in the management of anaphylaxis in children. The introduction of EIAs was accompanied by standard operating procedures and a training of the staff.…”