Which medications in the drug class Anticholinergics are used in the treatment of Scorpion Envenomation?

Updated: Nov 09, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Anticholinergics

Anticholinergics are used to counteract scorpion-induced cholinergic symptoms. Current recommendations are for use in treating symptomatic bradycardias. Traditionally, its use to dry venom-induced, excess, respiratory secretions has been warned against because of its potential adverse cardiopulmonary effects. It may exacerbate pulmonary edema and hypertension and may lead to a subsequent tachycardia. A recent case series has suggested relative efficacy and safety with its use in 5 pediatric patients treated for C sculpturatus sting. However, this should be considered an area in need of further study rather than a change in recommendations.

Atropine IV/IM (Atropair)

Atropine is used to increase the heart rate through vagolytic effects, causing an increase in cardiac output. It also treats bronchorrhea associated with scorpion envenomations. Atropine causes a reversible blockade of muscarinic receptors with subsequent anticholinergic effects. It has been used to reverse vagally induced symptomatic bradycardias, which may be associated with scorpion envenomation. Its use for dry secretions is debated. Atropine will not reverse the somatic or other cranial nerve symptoms.


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