A comparison of serum antivenom concentrations after intravenous and intramuscular administration of redback (widow) spider antivenom

被引：25

作者：

Isbister, Geoffrey K. ^{[1
,2
,3
]}

O'Leary, Margaret ^{[2
]}

Miller, Mark ^{[3
,4
]}

Brown, Simon G. A. ^{[5
,6
]}

Ramasamy, Sharmaine

James, Rosemary ^{[7
]}

Schneider, Jennifer S. ^{[3
]}

机构：

[1] Charles Darwin Univ, Trop Toxinol Unit, Menzies Sch Hlth Res, Darwin, NT, Australia

[2] Newcastle Mater Hosp, Dept Clin Toxicol & Pharmacol, Newcastle, NSW, Australia

[3] Univ Newcastle, Fac Hlth, Newcastle, NSW 2308, Australia

[4] John Hunter Hosp, Emergency Dept, Hunter Area Hlth Serv, Newcastle, NSW, Australia

[5] Univ Western Australia, Discipline Emergency Med, Perth, WA 6009, Australia

[6] Fremantle Hosp, Emergency Dept, Perth, WA, Australia

[7] Newcastle Mater Hosp, Dept Pharm, Newcastle, NSW, Australia

来源：

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY | 2008年 / 65卷 / 01期

关键词：

antivenom; widow spider; arachnidism; intramuscular administration; Latrodectus; envenoming;

D O I：

10.1111/j.1365-2125.2007.03004.x

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

AIMS There are no studies measuring antivenom concentrations following intramuscular administration. This study aimed to compare antivenom concentrations following intravenous and intramuscular administration of redback spider antivenom (RBSAV). METHODS Twenty patients recruited to a controlled trial comparing intramuscular and intravenous administration of antivenom had serial blood samples collected at 30 min intervals for 2 h after the administration of one or two doses of antivenom. Antivenom concentration was measured using an enzyme immunoassay. RESULTS Ten patients received intramuscular antivenom but antivenom could not be detected in serum after either one or two vials, at any time point. The median time of the final sample after commencement of antivenom treatment in these patients was 3.2 h (1.8 - 5 h). Ten patients received intravenous antivenom (three one vial and seven two or more vials) and antivenom was detected in all patients. CONCLUSIONS RBS AV given by the intramuscular route is unlikely to be effective in the treatment of redback (widow) spider bite.

引用

页码：139 / 143

页数：5

共 22 条

[1] Venoms, antivenoms and immunotherapy [J].

Chippaux, JP ;

Goyffon, M .

TOXICON, 1998, 36 (06) :823-846

[2] CLINICAL PRESENTATION AND TREATMENT OF BLACK-WIDOW SPIDER ENVENOMATION - A REVIEW OF 163 CASES [J].

CLARK, RF ;

WETHERNKESTNER, S ;

VANCE, MV ;

GERKIN, R .

ANNALS OF EMERGENCY MEDICINE, 1992, 21 (07) :782-787

[3] The safety and efficacy of antivenin Latrodectus mactans [J].

Clark, RF .

JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY, 2001, 39 (02) :125-127

[4]

CROWTHER JR, 1995, METHODS MOL BIOL, V42

[5]

Ellis Rodney M, 2005, Emerg Med Australas, V17, P152, DOI 10.1111/j.1742-6723.2005.00720.x

[6] The black widow spider genus Latrodectus (Araneae: Theridiidae):: phylogeny, biogeography, and invasion history [J].

Garb, JE ;

González, A ;

Gillespie, RG .

MOLECULAR PHYLOGENETICS AND EVOLUTION, 2004, 31 (03) :1127-1142

[7] Scorpion envenomation and serotherapy in Morocco [J].

Ghalim, N ;

El-Hafny, B ;

Sebti, F ;

Heikel, J ;

Lazar, N ;

Moustanir, R ;

Benslimane, A .

AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 2000, 62 (02) :277-283

[8] Pharmacokinetic-pharmacodynamic relationships of immunoglobulin therapy for envenomation [J].

Gutiérrez, JM ;

León, G ;

Lomonte, B .

CLINICAL PHARMACOKINETICS, 2003, 42 (08) :721-741

[9] Latrodectism: a prospective cohort study of bites by formally identified redback spiders [J].

Isbister, GK ;

Gray, MR .

MEDICAL JOURNAL OF AUSTRALIA, 2003, 179 (02) :88-91

[10] Antivenom treatment in arachnidism [J].

Isbister, GK ;

Graudins, A ;

White, J ;

Warrell, D .

JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY, 2003, 41 (03) :291-300

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