Effect of premedication with subcutaneous adrenaline on the pharmacokinetics and immunogenicity of equine whole IgG antivenom in a rabbit model

Herrera, María; Sánchez, Melvin; Machado, Anderson Silva; Ramírez, Nils; Vargas, Mariángela; Villalta, Mauren; Sánchez, Andrés; Segura, Álvaro; Gómez, Aarón; Solano, Gabriela; Gutiérrez, José Marı́a; León, Guillermo

doi:10.1016/j.biopha.2017.04.039

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Adverse reactions to antivenom may be early or late developing due to the involvement of different pathological pathways, including early developing IgE anaphylaxis, early developing non-IgE-mediated anaphylactoid reactions, and the IgG and IgM mediated late developing adverse reaction of serum sickness [ 49 , 145 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 , 198 ]. However, premedication with adrenalin has been shown to significantly reduce the incidence of early adverse reactions [ 193 , 199 , 200 , 201 , 202 , 203 ]. One study resulted in the contrary conclusion that adrenalin was not effective since 2 out of 11 (18%) patients receiving adrenalin had allergic responses while 20 out of 86 (23%) not receiving any form of premedication developed allergic responses [ 204 ].…”

Section: Issues and Controversies In Modern Medical Carementioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

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Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood. Tens of thousands of lives are lost to snakebites each year and hundreds of thousands of people will survive with some form of permanent damage and reduced work capacity. These numbers are well recognized as being gross underestimations due to poor to non-existent record keeping in some of the most affected areas. These underestimations complicate achieving the proper recognition of snakebite’s socioeconomic impact and thus securing foreign aid to help alleviate this global crisis. Antivenoms are expensive and hospitals are few and far between, leaving people to seek help from traditional healers or use other forms of ineffective treatment. In some cases, cheaper, inappropriately manufactured antivenom from other regions is used despite no evidence for their efficacy, with often robust data demonstrating they are woefully ineffective in neutralizing many venoms for which they are marketed for. Inappropriate first-aid and treatments include cutting the wound, tourniquets, electrical shock, immersion in ice water, and use of ineffective herbal remedies by traditional healers. Even in the developed world, there are fundamental controversies including fasciotomy, pressure bandages, antivenom dosage, premedication such as adrenalin, and lack of antivenom for exotic snakebites in the pet trade. This review explores the myriad of human-origin factors that influence the trajectory of global snakebite causes and treatment failures and illustrate that snakebite is as much a sociological and economic problem as it is a medical one. Reducing the incidence and frequency of such controllable factors are therefore realistic targets to help alleviate the global snakebite burden as incremental improvements across several areas will have a strong cumulative effect.

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Section: Issues and Controversies In Modern Medical Carementioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

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Developing a computational pharmacokinetic model of systemic snakebite envenomation and antivenom treatment

Morris

Blee

Hauert

2022

Toxicon

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Broncoespasmo durante anestesia para coelho submetido a apendicetomia: Relato de caso

Bedin¹,

Schultz²,

Bedin³

2020

Revista Científica Multidisciplinar Núcleo do Conhecimento

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A anestesia para animais de laboratório é motivo de preocupação biomédica e um dos dilemas mais conflitantes no debate bioético. O uso de anestésicos em cirurgia experimental é feito para promover a contenção do animal, de forma a atingir um grau razoável de relaxamento muscular e de produzir analgesia suficiente. Esta prática requer utilização de protocolos para a administração de doses seguras e eficientes. Este relato é sobre coelho da raça Nova Zelândia submetido a anestesia geral. Para a medicação pré-anestésica foi utilizado acepromazina 1 mg.kg-1 associada a cetamina 15 mg.kg-1 via subcutânea. Para a manutenção da anestesia foi utilizado isoflurano e oxigênio com a utilização de máscara laríngea número 1 e sistema inalatório Mapleson D sob respiração espontânea. Logo após a locação da máscara laríngea observou-se dificuldade respiratória. Na ausculta observou-se sibilos em ambas as bases pulmonares. Foi administrado dexametasona 500 mcg venosa e adrenalina 50 mcg subcutânea. Por 10 minutos foi mantido a ventilação controlada manual e posteriormente retornou-se à ventilação espontânea. Os ruídos adventícios reduziram e o procedimento transcorreu sem outras intercorrências.

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Effect of premedication with subcutaneous adrenaline on the pharmacokinetics and immunogenicity of equine whole IgG antivenom in a rabbit model

Cited by 3 publications

References 17 publications

Snakebite: When the Human Touch Becomes a Bad Touch

Snakebite: When the Human Touch Becomes a Bad Touch

Developing a computational pharmacokinetic model of systemic snakebite envenomation and antivenom treatment

Broncoespasmo durante anestesia para coelho submetido a apendicetomia: Relato de caso

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