Giving low-dose adrenaline to individuals bitten by a poisonous snake before treating them with snake antivenom is safe and reduced the risk of acute severe reactions to antivenom, report researchers from Sri Lanka and the United Kingdom (de Silva HA et al. PLoS Med. 2011;8:e1000435).
In a study of 1007 patients in 5 hospitals in Sri Lanka, the researchers randomized patients to receive low-dose adrenaline, promethazine, hydrocortisone, or placebo—alone or in any possible combination—immediately before treatment with an antivenom infusion. Compared with placebo, pretreatment with adrenaline reduced the odds of severe reactions to the antivenom by 43% at 1 hour and 38% over 3 hours. Promethazine and hydrocortisone had no significant effect.
Friedrich MJ. Treating Snakebites. JAMA. 2011;305(23):2402. doi:10.1001/jama.2011.833