eprintid: 10100052 rev_number: 30 eprint_status: archive userid: 608 dir: disk0/10/10/00/52 datestamp: 2020-06-09 11:01:05 lastmod: 2021-10-23 23:02:57 status_changed: 2020-11-04 13:53:05 type: article metadata_visibility: show creators_name: Moss, J creators_name: Jani, Y creators_name: Edwards, B creators_name: Tomlin, S creators_name: Rashed, AN title: Pharmacokinetic and pharmacodynamic evidence of adrenaline administered via auto-injector for anaphylactic reactions: a review of literature ispublished: inpress divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 note: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. abstract: Anaphylaxis is a severe allergic reaction that can lead to death if not treated quickly. Adrenaline (epinephrine) is the first‐line treatment for anaphylaxis and its prompt administration is vital to reduce mortality. Following a number of high‐profile cases, serious concerns have been raised, both about the optimal dose of intramuscular adrenaline via an auto‐injector and the correct needle length to ensure maximal penetration every time. To date, the public data are sparse on the pharmacokinetics–pharmacodynamics of adrenaline administered via an auto‐injector. The limited available literature showed a huge variation in the plasma concentrations of adrenaline administered through an auto‐injector, as well as variations in the auto‐injector needle length. Hence, delivering an effective dose during an anaphylaxis remains a challenge for both patients and healthcare professionals. Collaborative work between pharmacokinetics–pharmacodynamics experts, clinical triallists and licence holders is imperative to address this gap in evidence so that we can improve outcomes of anaphylaxis. In addition, we advise inclusion of expertise of human factors in usability studies given the necessity of carer or self‐administration in the uniquely stressful nature of anaphylaxis. date: 2020 date_type: published publisher: Wiley-Blackwell official_url: https://doi.org/10.1111/bcp.14438 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1788452 doi: 10.1111/bcp.14438 lyricists_name: Jani, Yogini lyricists_id: YHJAN61 actors_name: Jani, Yogini actors_name: Allington-Smith, Dominic actors_id: YHJAN61 actors_id: DAALL44 actors_role: owner actors_role: impersonator full_text_status: public publication: British Journal of Clinical Pharmacology citation: Moss, J; Jani, Y; Edwards, B; Tomlin, S; Rashed, AN; (2020) Pharmacokinetic and pharmacodynamic evidence of adrenaline administered via auto-injector for anaphylactic reactions: a review of literature. British Journal of Clinical Pharmacology 10.1111/bcp.14438 <https://doi.org/10.1111/bcp.14438>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10100052/1/Jani_bcp.14438.pdf