Antivenom therapy: efficacy of premedication for the prevention of adverse reactions

 

Victor Morais¹ 

 

1 Department of Biotechnology, Institute of Hygiene, Faculty of Medicine, University of the Republic, Uruguay, Av. Alfredo Navarro, 3051 Montevideo, Uruguay.

 

ABSTRACT:

Antivenoms or antitoxins have been effectively used for more than a century. During this time, these products have always proven to be highly effective in the treatment of infections and envenomations. However, antivenoms did not exhibit good safety results in their initial applications. After many improvements, antivenoms have substantially better safety profiles but still have some side effects. Due to the occurrence of adverse reactions, the practice of using premedication with the intent to decrease side effects has become accepted or mandatory in many countries. The drugs used for premedication belong to the histamine H1 antagonist, glucocorticoid and catecholamine groups. Currently, this practice is being questioned due to low or controversial efficacies in clinical assays. In this article, we discuss the causes of adverse reactions, the mechanisms of drugs that block the undesired effects and the results obtained in clinical trials. Although these three families of drugs could have positive effects on reducing adverse reactions, only adrenaline has demonstrated positive results in clinical assays.

 

Keywords: Premedication; Snakebite accident; Adverse reactions; Hydrocortisone; Antihistaminic; Adrenaline

 

Received: September 25, 2017.

Accepted: February 07, 2018.

 

Correspondence: vmorais@higiene.edu.uy

 

Authors’ contributions

The author read and approved the final manuscript.

 

Competing interests

The author declares that he has no competing interests.