Home' Australian Pharmacist : August 2011 Contents Vol. 30 -- August #08
anxiety, fear, restlessness, headache,
dizziness, palpitations, tremor and
pallor. Serious side effects are rare.
Correct use and storage
Adrenaline autoinjectors are designed
to administer a single fixed dose of
adrenaline into the outer mid-thigh
muscle and can be administered
through a single layer of clothing.
EpiPen is designed to be held in the
mid-section with the fingers and
thumb forming a fist around the
device. The device is activated by
removing the safety cap and pressing
firmly against the outer mid-thigh
until a click is heard. The new look
EpiPen has the same administration
technique. Colour-coded ends have
been used in its design to facilitate
correct administration. The orange
needle sheath extends after use to
prevent needle stick injury.
The administration of Anapen
requires the removal of the black
needle shield and the grey safety cap.
Anapen is also held firmly against
the outer mid-thigh, but is activated
by depressing a red button with the
thumb so it clicks.
Both devices should be held in place
for 10 seconds after activation.
It is important for pharmacists to
educate patients about how to use
the device prescribed using the
appropriate adrenaline autoinjector
trainer. Patients need to check the
expiry date of the device regularly.
Adrenaline is heat sensitive and ideally
should be stored at room temperature.
Refrigerating adrenaline autoinjectors
can affect the autoinjector mechanism.
ASCIA Action Plans for
ASCIA Action Plans include the signs/
symptoms of anaphylaxis and provide
instruction of when and how to
administer the adrenaline autoinjector.
A copy of the patient's ASCIA Action
Plan should always be stored with
their adrenaline autoinjector.
ASCIA has three types of Action Plans:
• ASCIA Action Plan for Allergic
Reactions -- a green Action Plan for
patients with mild/moderate allergic
reactions who are not thought to
be at risk of anaphylaxis and have
not been prescribed an adrenaline
• ASCIA Action Plan for Anaphylaxis
(personal) -- a red Action Plan
for all patients who are at
risk of anaphylaxis and have
been prescribed an adrenaline
• ASCIA Action Plan for Anaphylaxis
(general) -- an orange Action Plan
useful as a poster or for storage
with an adrenaline autoinjector in
first aid kits.
The red and orange Action Plans are
available for EpiPen, new-look EpiPen
and Anapen. ASCIA Travel Plans
are useful for patients travelling on
During the phaseout of the original
Epipen and release of the new-look
EpiPen, pharmacists have an essential
role in educating patients on how to
use the device and checking patients
have the correct ASCIA Action Plan for
the device dispensed.
The ASCIA website (www.allergy.org.
au) has anaphylaxis resources and
1. Simons E. Anaphylaxis. J Allergy Clin Immunol. 2010;
2. Australasian Society of Clinical Immunology and
Allergy (ASCIA). Guidelines for adrenaline autoinjector
prescribing. Sydney: ASCIA; [online] 2009 [accessed
Aug 2010]. At: www.allergy.org.au/images/stories/
3. Simons FE. Epinephrine (adrenaline) in the first-aid, out-
of-hospital treatment of anaphylaxis. Novartis Found
Symp. 2004; 257:228--43; discussion 243--7, 276--85.
Yaz and Yasmin
Bayer has acknowledged information
on oral contraceptives released by
the Therapeutic Goods Administration
(TGA) in early July. The company says
it worked closely with the TGA during
its review of the product information
for its drospirenone-containing oral
contraceptives, and in the continued
interest of patient safety, it had
made all relevant information on
the drospirenone-containing oral
contraceptives -- Ya z and Yasmin
-- available to the TGA to assist
with its review.
Head of Regulatory Affairs, Bayer
Australia and New Zealand, Elizabeth
Thompson, said Bayer fully supports
the review of the data by the TGA, as
patient safety is an absolute priority
for the pharmaceutical company.
'Bayer is working with the TGA to
implement minor amendments to the
product information for drospirenone-
containing oral contraceptives. Many
Australian women are aware of the
benefits of oral contraceptives as a
reliable form of contraception. A large
body of evidence shows the overall
risk of venous thromboembolism (VTE)
due to drospirenone-containing oral
contraceptives remains unchanged.
'At Bayer, our priority is the safety
of patients and the quality use of
medicine, ensuring patients, doctors
and healthcare practitioners are aware
of the most appropriate use of all our
' she said.
Prevenar 13 (pneumococcal
polysaccharide conjugate vaccine,
13-valent adsorbed), is now available
on the National Immunisation Program
(NIP) for the active immunisation of
infants against pneumococcal disease
(including invasive disease, pneumonia
and acute otitis media).1 Prevenar 13
replaces the current vaccine Prevenar
(pneumococcal conjugate vaccine,
7-valent), and provides protection
against Streptococcus pneumoniae
serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14,
18C, 19F, 23F, and strain 19A,1 which
is now the leading cause of invasive
pneumococcal disease in Australia.2
Prevenar 13 became available on the
NIP in all states and the Australian
Capital Territory on 1 July. It is given
in three doses at 2, 4 and 6 months
of age with infants at medical risk of
pneumococcal infection receiving a
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