Anticholinesterases as antidotes to envenomation of rats by the death adder (Acanthophis antarcticus)

Flachsenberger, W.; Mirtschin, Peter

doi:10.1016/0041-0101(94)90019-1

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…Neurotoxic snakebites, curare-derived nondepolarizing neuromuscular blocking agents, and myasthenia gravis all have in common interruption of the transmission of acetylcholine at nicotinic cholinergic receptors. Animal research strongly suggests that early treatment with parenteral anticholinesterase agents greatly reduces mortality from neurotoxic envenomation [25,26], while numerous studies and consensus reports agree that rapid transport and early treatment at capable facilities is a key to mortality reduction in human victims [13–16,27,28]. …”

Section: Introductionmentioning

confidence: 99%

Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation

Lewin

Bickler

Heier

et al. 2013

Clinical Case Reports

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Key Clinical MessageNeurotoxic snake envenomation can result in respiratory failure and death. Early treatment is considered important to survival. Inexpensive, heat-stable, needle-free, antiparalytics could facilitate early treatment of snakebite and save lives, but none have been developed. An experiment using aerosolized neostigmine to reverse paralysis suggests how early interventions could be developed.

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Section: Introductionmentioning

confidence: 99%

Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation

Lewin

Bickler

Heier

et al. 2013

Clinical Case Reports

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“…Mice were pseudorandomized in batches of 5 with tails marked 1 to 5 stripes by Sharpie felt tip pen to receive intraperitoneal (IP) injections of N. naja venom (2.5× LD50, N = 20; 5× LD50, N = 10 and 10× LD50, N = 10) concomitantly with atropine, which blunts the muscarinic effects of neostigmine and has previously been shown to have no effect on LD50 when experimentally injected with snake venom [16]. The IP agents (venom and atropine) were adjusted for the weight of each individual mouse by the facility veterinarian and injected by a single technician who was not aware of the hypothesis and who also recorded the survival times.…”

Section: Methodsmentioning

confidence: 99%

“…The early use of AChEIs leads to a considerable increase in the LD50 in mice and rats having undergone experimental envenomation [15, 16]. Our study is distinguished from those by the replacement of parenteral neostigmine with topically applied IN neostigmine.…”

Section: Introductionmentioning

confidence: 97%

Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model ofNaja naja(Indian Cobra) Envenomation

Lewin

Samuel

Wexler

et al. 2014

Journal of Tropical Medicine

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Objective. Most snakebite deaths occur prior to hospital arrival; yet inexpensive, effective, and easy to administer out-of-hospital treatments do not exist. Acetylcholinesterase inhibitors can be therapeutic in neurotoxic envenomations when administered intravenously, but nasally delivered drugs could facilitate prehospital therapy for these patients. We tested the feasibility of this idea in experimentally envenomed mice. Methods. Mice received intraperitoneal injections of Naja naja venom 2.5 to 10 times the estimated LD50 and then received 5 μL neostigmine (0.5 mg/mL) or 5 μL normal saline by nasal administration. Animals were observed up to 12 hours and survivors were euthanized. Results. 100% of control mice died. Untreated mice injected with 2.5× LD50 Naja naja died at average 193 minutes after injection, while 10 of 15 (67%) of treated mice survived and were behaviorally normal by 6 hours (P < 0.02). In the 5× LD50 group, survival was prolonged from 45 minutes to 196 minutes (P = 0.01) and for 10× LD50 mice, survival increased from 30 to 175 minutes (P < 0.02). Conclusion. This pilot suggests that intranasal drugs can improve survival and is the first direct demonstration that such an approach is plausible, suggesting means by which treatment could be initiated before reaching the hospital. Further investigation of this approach to neurotoxic and other types of envenomation is warranted.

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“…Flachsenberger and Mirtschin 24 investigated use of neostigmine combined with atropine as a treatment for death adder envenomation in rats. Injections of neostigmine and atropine were repeated every 10 to 100 min depending upon clinical signs.…”

Section: Discussionmentioning

confidence: 99%

Four cases of snake envenomation responsive to death adder antivenom

Swindells

Russell²,

Angles³

et al. 2006

Aust Veterinary J

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Death adder envenomation is rare in humans and there is only one brief report previously in dogs. This paper details three cases of canine common death adder (Acanthophis antarcticus) envenomation and one case of bardick (Echiopsis curta) envenomation which were responsive to death adder antivenom. The available literature on death adder envenomations is also reviewed. The main clinical sign in the four dogs was severe lower motor neuron paralysis. There was no clinical evidence of coagulopathy or myopathy. Use of a snake venom detection kit was essential for selection of appropriate antivenom. Death adder and bardick envenomation in dogs potentially has a good prognosis if sufficient antivenom is administered and intensive supportive care is available.

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Anticholinesterases as antidotes to envenomation of rats by the death adder (Acanthophis antarcticus)

Cited by 17 publications

References 10 publications

Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation

Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation

Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model ofNaja naja(Indian Cobra) Envenomation

Four cases of snake envenomation responsive to death adder antivenom

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