Evaluation of The effects of Anti-Inflammatory Drugs on Local and Systemic manifestations of snakebite: A cross-sectional study

Research Letter

J Venom Res 
(2021), Vol 11, 21-25

Published online: 25 May 2021

Full Text (Dorooshi ~298kb)

Gholamali Dorooshi1, Zahra Nabi Javid2, Rokhsareh Meamar1*,  Ziba Farjzadegan3, Maryam Nasri4 and Nastaran Eizadi-Mood1

1Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2Department of General Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4MRCGP, MFSRH, Barnet CCG, London, UK

*Correspondence to: Rokhsareh Meamar, meamar@pharm.mui.ac.ir

Received: 15 March 2021 | Revised: 25 May 2021 | Accepted: 25 May 2021

© Copyright The Author(s). This is an open access article, published under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0). This license permits non-commercial use, distribution and reproduction of this article, provided the original work is appropriately acknowledged, with correct citation details.


Although the predominant treatment for snakebite is the antivenom, other treatments are also considered. We studied the effects of single or multiple-doses of anti-inflammatory drugs on local, systemic and laboratory findings of the snakebite victims. In this cross-sectional study, 101 patients (90 male: 89.1%) with snakebite envenomation who were admitted to the Medical Toxicology Center of Khorshid Hospital, Isfahan, Iran, were investigated. One group (35 patients: 34.7%) received a single-dose  of anti-inflammatory drugs containing chlorpheniramine (10mg intramuscular injection) with cimetidine (200mg intravenous injection) or ranitidine (50mg intravenous injection) plus hydrocortisone (100mg intravenous injection). The other 55 patients (54.5%) received multiple doses of the same drug combination every 8hr until the symptoms resolved. Local, systemic symptoms and laboratory findings on admission, and during 24hr and 48hr of admission, were recorded. The frequency of the localized signs of inflammation (p=0.03), swelling (p<0.001) and bruising (p<0.001) showed a significant difference between the two treated groups. In addition, the recovery time in the patients who received multiple doses was faster (p<0.001). There was no significant difference in any of the systemic signs, laboratory findings or the outcome between the patients in the various groups during hospitalization. Our data indicate that the administration of multiple doses of anti-inflammatory drugs had a greater effect on reducing local symptoms of snakebite including inflammatory manifestations.

KEYWORDS: Envenomation, Snakebite, Anti-Inflammatory Drugs, Symptoms


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