Advanced Engineering for Critical Situations—
in the Palm of Your Hand
Meridian's state-of-the-art auto-injectors have been engineered and designed for use in certain extreme emergency situations. Select Meridian auto-injectors (Antidote Treatment Nerve Agent, Auto-Injector (ATNAA) (atropine and pralidoxime chloride injection), AtroPen® Auto-Injector (atropine injection), and Diazepam Auto-Injector C-IV (diazepam injection)) have undergone rigorous testing by the United States Military and have been shown to be rugged and dependable. Other Meridian auto-injector products are built to that same standard.1
The United States Military Standard 810 (MIL-STD-810) compliance tests are a series of performance and manufacturing guidelines set by the US Department of Defense for military and commercial equipment and applications. These guidelines specify allowable parts and environmental condition ranges in which a device must be able to operate to be in compliance.1
Please see Important Safety Information and full Prescribing Information for products mentioned.
Meridian's Auto-Injectors Have Been Designed to Meet or Exceed MIL-STD-810 Testing Standards1
Mechanical Reliability: Exceeded 99.5% reliability for activation force, post-activation needle length, delivered volume, and speed of discharge
Completeness of Injection: Complete injection of appropriate amount of drug achieved within 10 seconds
Rough Handling: Integrity of auto-injector safety cap maintained after drop test
Compression Load: Auto-injector did not trigger with the safety cap in place under 20-lb load
AtroPen®: The First of Its Kind2
Initially called the ACE Auto-Injector, the AtroPen® Auto-Injector was the first commercially available, single-chamber, pressure-activated auto-injector platform developed. At the time of its creation, the AtroPen® platform replaced the metal syrettes traditionally used to deliver nerve agent poisoning antidotes to soldiers. The AtroPen® Auto-Injector is a single-chamber, wet, 0.7-mL, prefilled, self-injecting, automatic syringe.
Click here to explore AtroPen® technology in 3D.
ComboPen®: A Long-Standing Technology Platform2
Designed to address the US Military's need for an auto-injector that could combine up to 3 drugs in a 2-mL vial, ComboPen® was a success. The technology platform has been expanded for use with other medications and continues to be used today. Currently, the ComboPen® Auto-Injector is a single-chamber, wet, ≤3.0-mL, prefilled, self-injecting, automatic syringe.
Click here to explore ComboPen® technology in 3D.
BinaJect®: Innovative Drug Delivery Technology
Designed to address the distinct properties of the medications being delivered, the BinaJect® Auto-Injector has two separate liquid chambers. It delivers the medications sequentially through the same needle, so there's no need for two separate injections. The BinaJect® Auto-Injector is a two-chamber, wet, 0.7-mL/wet, 2.0-mL, prefilled, self-injecting, automatic syringe.
Click here to explore BinaJect® technology in 3D.
AtroPen, BinaJect, and ComboPen are registered trademarks of Meridian Medical Technologies™, Inc., a Pfizer company.
References: 1. Data on file. Meridian Medical Technologies™, Inc., a Pfizer company, Columbia, MD. 2. Mesa M. Auto-injector evolution. From battlefield to backpack: evolution of the auto-injector. Drug Deliv Technol. 2009;9(3):42-46.
Antidote Treatment Nerve Agent, Auto-Injector (ATNAA) (atropine and pralidoxime chloride injection)
Indication: For the treatment of poisoning by organophosphorous nerve agents as well as organophosphorous insecticides.
This product is only FDA approved for United States military personnel.
Important Safety Information
The ATNAA Auto-Injector should be administered by emergency medical services personnel who have had adequate training in the recognition and treatment of nerve agent or insecticide intoxication. It is intended as an initial treatment of the symptoms of organophosphorous nerve agent or insecticide poisoning; definitive medical care should be sought immediately.
Individuals should not rely solely upon agents such as atropine and pralidoxime to provide complete protection from organophosphorous nerve agents and insecticide poisoning. Primary protection against exposure to organophosphorous nerve agents and insecticides is the wearing of protective garments including masks designed specifically for this use. Evacuation and decontamination procedures should be undertaken as soon as possible. Medical personnel assisting evacuated victims of organophosphorous nerve agent or insecticide poisoning should avoid contaminating themselves by exposure to the victim's clothing.
In the presence of life-threatening poisoning by organophosphorous nerve agents or insecticides there are no absolute contraindications to the use of ATNAA. When symptoms of poisoning are not severe, ATNAA should be used with extreme caution in people with heart disease, arrhythmias, recent myocardial infarction, severe narrow angle glaucoma, pyloric stenosis, prostatic hypertrophy, significant renal insufficiency, chronic pulmonary disease, or hypersensitivity to any compound of the product.
No more than three doses should be administered unless definitive medical care (eg, hospitalization, respiratory support) is available. Elderly people and children may be more susceptible to the effects of atropine. ATNAA is pregnancy Category C and should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Safety and effectiveness in children have not been established.
Muscle tightness and sometimes pain may occur at the injection site. The most common adverse effects of atropine can be attributed to its antimuscarinic action and include dryness of mouth, blurred vision, dry eyes, photophobia, confusion, headache, and dizziness among others. Pralidoxime chloride's adverse effects include changes in vision, dizziness, headache, drowsiness, nausea, tachycardia, increased blood pressure, muscular weakness, dry mouth, emesis, rash, dry skin, hyperventilation, decreased renal function, excitement, manic behavior, and transient elevation of liver enzymes and creatine phosphokinase. When atropine and pralidoxime are used together, the signs of atropinization may occur earlier than might be expected when atropine is used alone.
View full Prescribing Information for ATNAA (PDF).
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AtroPen® Auto-Injector (atropine injection)
Indication: The AtroPen® Auto-Injector is indicated for the treatment of poisoning by susceptible organophosphorous nerve agents having cholinesterase activity as well as organophosphorous or carbamate insecticides.
The AtroPen® Auto-Injector should be used by persons who have had adequate training in the recognition and treatment of nerve agent or insecticide intoxication. The AtroPen® is intended as an initial treatment of the muscarinic symptoms of insecticide or nerve agent poisonings (generally breathing difficulties due to increased secretions); definitive medical care should be sought immediately.
Important Safety Information
In the face of life-threatening poisoning by organophosphorous nerve agents and insecticides, there are no absolute contraindications for the use of atropine.
Primary protection against exposure to chemical nerve agents and insecticide poisoning is the wearing of protective garments including masks designed specifically for this use. Individuals should not rely solely upon antidotes such as atropine and pralidoxime to provide complete protection from chemical nerve agents and insecticide poisoning. Immediate evacuation from the contaminated environment is essential. Decontamination of the poisoned individual should occur as soon as possible.
AtroPen® should be administered with extreme caution to individuals with the following disorders when the symptoms of nerve agent poisoning are less severe: individuals who are hypersensitive to any component of the product, disorders of heart rhythm such as atrial flutter, severe narrow angle glaucoma, pyloric stenosis, prostatic hypertrophy, significant renal insufficiency, or a recent myocardial infarction.
No more than three doses should be administered unless under the supervision of trained medical personnel. Children and the elderly may be more susceptible to the pharmacologic effects of atropine.
Severe difficulty in breathing requires artificial respiration in addition to the use of atropine since atropine is not dependable in reversing the weakness or paralysis of the respiratory muscles.
Pregnancy Category C. Atropine should be administered to a pregnant woman only if clearly needed.
Mild to moderate pain may be experienced at the site of injection. The major and most common side effects of atropine can be attributed to its antimuscarinic action and include dryness of the mouth, blurred vision, photophobia, confusion, headache, dizziness, and anhidrosis among others.
View full Prescribing Information for AtroPen® (PDF).
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Diazepam Auto-Injector C-IV (diazepam injection)
Indications: Diazepam is indicated for the management of anxiety disorders for the short-term relief of the symptoms of anxiety, excluding mild and moderate degrees of anxiety and anxiety related disorders.
In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis.
As an adjunct prior to endoscopic procedures if apprehension, anxiety or acute stress reactions are present, and to diminish the patient's recall of the procedures.
Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology, spasticity caused by upper motor neuron disorders, athetosis, stiff man syndrome, and tetanus.
Diazepam injection is a useful adjunct in status epilepticus and severe recurrent convulsive seizures.
Diazepam is useful premedication for relief of anxiety and tension in patients who are to undergo surgical procedures.
Important Safety Information
Intravenous administration of diazepam with the auto-injector is contraindicated.
Diazepam injection is contraindicated in patients with a known hypersensitivity to this drug; acute narrow angle glaucoma; and open angle glaucoma unless patients are receiving appropriate therapy.
Diazepam auto-injector is to be administered only by the intramuscular (IM) route.
Extreme care must be used in administering injectable diazepam to the elderly, to very ill patients and to those with limited pulmonary reserve. Concomitant use of barbiturates, alcohol, or other central nervous system depressants increases depression with increased risk of apnea. Resuscitative equipment including that necessary to support respiration should be readily available.
Diazepam injection should not be administered to patients in shock, coma, or in acute alcoholic intoxication with depression of vital signs.
Patients receiving diazepam should be cautioned against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle.
The use of diazepam during the first trimester of pregnancy should almost always be avoided. Diazepam injection is not recommended for obstetrical use.
The cumulative maximum dose of diazepam should not exceed 30 mg; the interval between doses should be no less than 10 minutes.
Side effects most commonly reported with diazepam injection are drowsiness, fatigue and ataxia, venous thrombosis, and phlebitis at the site of injection. Manifestations of diazepam overdosage include somnolence, confusion, coma and diminished reflexes.
Withdrawal symptoms have occurred following the abrupt discontinuation of diazepam.
View full Prescribing Information for Diazepam (PDF).
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