BACKGROUNDCoagulopathy after snake bite is well known; however, cardiac tamponade as a manifestation of coagulopathy is rare.OBJECTIVETo report a case of pericardial hemorrhage with cardiac tamponade after Russell viper bite.CASE REPORTA 26-year-old man developed breathlessness after being bitten by a Russell viper. The clinical and laboratory follow-up of this case confirmed the clinical diagnosis of toxin-induced disseminated intravascular coagulation. Interestingly, pericardial hemorrhage with large pericardial effusion was evident clinically as well as on electrocardiogram and echocardiogram, as an initial presentation without any other bleeding manifestations. The patient developed cardiac arrest and was revived with cardiopulmonary resuscitation. Emergency pericardiocentesis was carried out. He was given fresh frozen plasma in addition to snake antivenin along with symptomatic management. On the third day of hospitalization, the patient's clinical and laboratory profile returned to normal and he was discharged on the fifth day.CONCLUSIONPericardial hemorrhage may be due to toxin-induced myocardial damage or pericardial vessel injury coupled with coagulopathy, possibly in conjunction with vasculitis or endothelial damage. Practitioners and physicians should suspect and search for pericardial effusion in snake bite victims who develop breathlessness, and treat it vigorously in addition to antivenin therapy.

01 Nov 2006·Medicina ClínicaQ4 · MEDICINE

Disponibilidad de antídotos en los ámbitos sanitarios de Cataluña

Q4 · MEDICINE

Article

Author: Dolors Soy Muner ; Santiago Nogué Xarau ; Raquel Aguilar Salmerón

BACKGROUND AND OBJECTIVEAcute poisoning can be treated in different hospital and extrahospital health services. Thus, availability of antidotes in hospital pharmacies, emergency departments and health centres play an important role in poisoning treatment.MATERIAL AND METHODThis is a descriptive and transversal study of antidotes availability in different health services of Catalonia (Spain). From April to May 2005, a proper questionnaire was sent to 50 different health centres: 28 basic health centres (including medical ambulances) and 22 hospitals with a distinct medical complexity level, to assess the qualitative (QLA) and quantitative availability (QTA) of antidotes.RESULTSQLA resulted to be 82% in extrahospital health centres and 50% in medical ambulances. QTA was 94% for ambulances, whereas, in health centres, differences were observed between rural (55%) and urban (33%) areas. Regarding basic general hospitals (level 1), reference hospitals (level II) and high technology hospitals (level III) the QLA showed values of 39, 54 and 55%, respectively, and the QTA came about 70, 54 y 54.5%, in that order. Furthermore, lack of adequate stocking was observed for compounded formulations, such as albumin, starch, ipecacuanha syrup or IV ethanol, and for essential antidotes as snake antivenin, digoxin immune Fab or hydroxocobalamine.CONCLUSIONSThere is understocking of poisoning antidotes throughout the health services of Catalonia. Heterogeneity was observed between services with a medical complexity level. The main deficiencies are found in antidotes that, to date, are available as compounded formulations or imported from other countries.

01 Jul 1986·Zhongguo yao li xue bao = Acta pharmacologica Sinica

[Absorption and distribution of 125I-modified snake neurotoxin in rats].

Article

Author: Sun, J ; Mao, Q W ; Chen, Q ; Zhang, L M ; Wu, N H ; Gao, Z F ; Wu, D L

100 Deals associated with Snake Antivenin(Biological E. Ltd.)

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