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

Table 2 Premedication used in antivenom treatment

Drug	Possible adverse reaction	Mechanism Involved	Clinical trial efficacy
Adrenaline	Anaphylactic Non IgE anaphylactic	Strong actions that directly oppose the effects triggered by mast cell and basophil activation. Vasoconstrictor and cardiac stimulant.	Yes
Glucocorticoids	Anaphylactic Non IgE anaphylactic Serum sickness Pyrogenic	Phospholipase A and cyclooxygenase inhibition. Mast cell membrane stabilization. General immunosuppressant effects	No^a
Antihistamines	Non IgE anaphylactic	Reduce or block the actions of histamine by reversible competitive binding to the H1 receptor	No^a

^aGlucocorticoids and antihistamines alone did not show efficacy but two trials show some efficacy using hydrocortisone together with an antihistamine

ISSN: 1678-9199