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November 28, 1966

Shock Following Snakebite

JAMA. 1966;198(9):1035. doi:10.1001/jama.1966.03110220119045

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To the Editor:—  Drs. Shubin and Weil are to be complimented on their fine paper, "Failure of Corticosteroids to Potentiate Sympathomimetic Pressure Response During Shock" (197:808, 1966). Their findings that the glucocorticoids do not augment the pressor action of sympathomimetic drugs in patients with circulatory shock due to sepsis, myocardial infarction, loss of blood volume, and anaphylaxis are consistent with our own observations that these drugs do not alter mean arterial pressure in patients with shock following rattlesnake venom poisoning. We have also found that the response to glucocorticoid hormones administered during the shock associated with rattlesnake venom poisoning, and in the absence of prior treatment with vasopressor amines, is not consistent. In some cases there has been a slight increase in cardiac output but no significant arterial pressure change. This may be due to the decreased arterial resistance as described by Sambhi, Weil, and Udhoji (Amer J Physiol