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Estimation of available epinephrine dose in expired and discolored autoinjectors via quantitative smartphone imaging

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Abstract

Epinephrine autoinjectors (EAIs) are important first aid medications for treating anaphylaxis. A 10-fold price increase over the past 12 years and evidence that expired EAIs may still contain significant doses of available epinephrine have motivated interest in the efficacy of expired EAIs as treatments of last resort. Degradation of expired EAIs, which can be caused by improper storage conditions, results in various degrees of discoloration of the epinephrine solution. Previous studies have determined that significant epinephrine remains available in expired EAIs, but these have only considered EAIs that show no discoloration. Here, we investigate the potential for colorimetric estimation of available epinephrine dose based on the degree of discoloration in expired EAIs. The correlation of available epinephrine dose and time since expiration date was poor (r = − 0.37), as determined by an industry standard UHPLC protocol. Visible absorbance of the samples integrated across the range 430–475 nm correlated well with available epinephrine dose (r = − 0.71). This wavelength corresponds to the blue channel of a typical smartphone camera Bayer filter. Smartphone camera images of the EAI solutions in various illumination conditions were analyzed to assign color indices representing the degree of discoloration. Color index of the samples showed similar correlation (|r| > 0.7) with available epinephrine dose as that of visible spectrophotometry. Smartphone imaging colorimetry is proposed as a potential point-of-use epinephrine dose estimator for expired and degraded EAIs.

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Acknowledgments

We would like to thank Dr. Seth C. Hawkins MD for his interest in the project and supplying the EAIs that were used in testing.

Funding

This work was supported by start-up funding provided by the University of Tennessee, College of Arts and Sciences, and the Department of Chemistry.

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Authors and Affiliations

  1. Department of Chemistry, University of Tennessee, Knoxville, TN, 37996, USA

    Amirus Saleheen & Christopher A. Baker

  2. Fellow Academy Wilderness Medicine, Wilderness Medical Society; National Park Service, Obed Wild and Scenic River and Big South Fork National River and Recreation Area; Appalachian Mountain Rescue Team, Oak Ridge, TN, 37830, USA

    Bill M. Campbell

  3. NeuroNET Research Center, University of Tennessee, Knoxville, TN, 37996, USA

    Bill M. Campbell, Rebecca A. Prosser & Christopher A. Baker

  4. Department of Biochemistry and Molecular Biology, University of Tennessee, Knoxville, TN, 37996, USA

    Rebecca A. Prosser

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  1. Amirus Saleheen
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Correspondence to Christopher A. Baker.

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Saleheen, A., Campbell, B.M., Prosser, R.A. et al. Estimation of available epinephrine dose in expired and discolored autoinjectors via quantitative smartphone imaging. Anal Bioanal Chem 412, 2785–2793 (2020). https://doi.org/10.1007/s00216-020-02505-y

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  • DOI: https://doi.org/10.1007/s00216-020-02505-y

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