Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus).

OBJECTIVE

The efficacy of nifedipine and prazosin in combination or alone in the management of cardiovascular manifestations caused to Mesobuthus tamulus poisoning was investigated.

DESIGN

Observation and study.

SETTING

Hospital at Mahad, Maharashtra, India.

SUBJECTS

62 patients who had been stung by a red scorpion were admitted from January to December 1990: 18 with hypertension, 15 with supraventricular tachycardia, 11 with pulmonary oedema, and 18 with local pain at the site of sting but no systemic involvement. Two patients with massive life-threatening pulmonary oedema were given intravenous sodium nitroprusside.

RESULTS

The combination of nifedipine and prazosin was more successful in preventing myocardial damage in 16 patients with hypertension than was nifedipine alone in two other patients with hypertension. Prazosin alone helped to alleviate the cardiovascular manifestations in eight patients with pulmonary oedema and 15 with supraventricular tachycardia. One patient with pulmonary oedema died and two recovered after they were given intravenous sodium nitroprusside.

CONCLUSION

Nifedipine alone did not prevent myocardial damage unless the peripheral action of venom was blocked by prazosin.