Accepted
at 10:06 p.m. Oct, 31, 2023
by
Alex
Author:
AbdelrahmanMahmoud
Rationale for change
Just completed the parentheses.
from (i.e. NSAIDs/opioids/benzos
to (i.e. NSAIDs/opioids/benzos)
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- Calcium gluconate is not effective and no longer recommended
- Benzos to control muscle spasms, opioids for pain
- Consider toxicology referral for antivenom when symptoms are refractory to supportive care
Photo credit: Shenrich91, CC BY-SA 3.0, via Wikimedia Commons
Lecture Notes
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Missed Questions
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Pathoma
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Boards and Beyond
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First Aid
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Sketchy
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Sketchy 2
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Sketchy Extra
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Picmonic
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Pixorize
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Physeo
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Bootcamp
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OME
Additional Resources
NIH
Envenomation Classification:
Mild Envenomation- Local pain and muscle spasms at bite site only
Moderate to Severe Envenomation- Pain radiating up bitten extremity. Systemic symptoms.
Systemic Symptoms include: diaphoresis, n/v and headache
Venom MOA:
Black widow neurotoxin exerts toxic effects in the CNS by depolarizing neurons, by increasing
[Ca2+] and by stimulating uncontrolled exocytosis of neurotransmitters from nerve terminals. This leads to uncontrolled muscle spasms (NIH).
Treatment Rationale:
Bites are rarely life-threatening and treatment is primarily supportive pain management. Most patients have mild envenomation which can be managed with wound care and oral NSAIDs.
Moderate-severe envenomation may lead to muscle spasms restricting breathing. Benzodiazepines (IV) may be used to relax muscles and reduce spasms. Pain may be managed with IV opioids. IV ondansetron may be used for n/v.
A toxicologist should be consulted prior to antivenom administration due to possible adverse effects. Antivenom is not administered in the majority of cases but is indicated when symptoms are refractory to supportive care.
Envenomation Classification:
Mild Envenomation- Local pain and muscle spasms at bite site only
Moderate to Severe Envenomation- Pain radiating up bitten extremity. Systemic symptoms.
Systemic Symptoms include: diaphoresis, n/v and headache
Venom MOA:
Black widow neurotoxin exerts toxic effects in the CNS by depolarizing neurons, by increasing
[Ca2+] and by stimulating uncontrolled exocytosis of neurotransmitters from nerve terminals. This leads to uncontrolled muscle spasms (NIH).
Treatment Rationale:
Bites are rarely life-threatening and treatment is primarily supportive pain management. Most patients have mild envenomation which can be managed with wound care and oral NSAIDs.
Moderate-severe envenomation may lead to muscle spasms restricting breathing. Benzodiazepines (IV) may be used to relax muscles and reduce spasms. Pain may be managed with IV opioids. IV ondansetron may be used for n/v.
A toxicologist should be consulted prior to antivenom administration due to possible adverse effects. Antivenom is not administered in the majority of cases but is indicated when symptoms are refractory to supportive care.
One by one
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