Anaphylaxis Checklist for Pharmacists

1. Provide advice

Provide advice about medications for treating allergic reactions. Advise patients that adrenaline (epinephrine) is the first line treatment for anaphylaxis and that antihistamines should not be used as initial treatment for anaphylaxis even when requested by patients. If using antihistamines for mild to moderate allergic reactions, non-sedating antihistamines should be used.
Advise patients with unconfirmed allergic reactions to see their medical practitioner.

2. Dispense adrenaline autoinjectors and teach patients/carers how to use them

Only dispense the specific adrenaline (epinephrine) autoinjector prescribed (e.g. EpiPen®).
Appropriate dose for weight: 10-20kg - 0.15mg device; Over 20kg - 0.30mg device.
Teach the patient and carer how to use their prescribed adrenaline autoinjector using a matching trainer device and provide Consumer Medicine Information. Training must be brand specific.
Remind patients and carers to check the expiry date of their autoinjector.
Inform patients and carers of expiry reminder clubs (e.g. EpiClub).

3. Provide adrenaline autoinjector education and confirm the patient has an ASCIA Action Plan for Anaphylaxis

Reinforce the need for the patient to ALWAYS carry their adrenaline autoinjector and their ASCIA Action Plan.
Educate about correct storage of adrenaline autoinjectors and how to protect the device from excessive heat or excessive cooling.
Check patients have the correct ASCIA Action Plan for the brand of adrenaline autoinjector dispensed.

4. Optimise asthma control

Check asthma is well managed and refer back to medical practitioner if further action is required. Patients at risk of anaphylaxis who have asthma that is not well controlled are at increased risk of fatal anaphylaxis.

5. Be prepared for an anaphylaxis emergency

Train staff to recognise the signs and symptoms of severe allergic reactions (anaphylaxis).
Train pharmacists on how to administer adrenaline autoinjectors and be prepared to administer in an anaphylaxis emergency.
Call an ambulance for assistance when treating a patient with acute anaphylaxis immediately after administration of an adrenaline autoinjector.
Display ASCIA Action Plans for Anaphylaxis to assist staff in recognising and responding to an anaphylaxis emergency.

Further information is available on the ASCIA website www.allergy.org.au

Anaphylaxis resources (ASCIA Action Plans, Travel Plans, FAQ, Guidelines):
www.allergy.org.au/hp/anaphylaxis-resources
Information for patient, consumers and carers including support organisations:
www.allergy.org.au/patients
ASCIA anaphylaxis and food allergy e-training for pharmacists:
www.allergy.org.au/hp/health-professionals-e-training
ASCIA anaphylaxis e-training for community (first aid):
www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community

Content updated June 2016