Corticoide pré soroterapia

Do Pará vem a questão recorrente dos corticoides pré soroterapia.

NÃO USO

Já escrevi sobre isso aqui no blog:

http://lachesisbrasil.blogspot.com/2011/03/nao-existe-eficacia-na-medicacao-pre.html


Não pretenderia e não acho possivel argumentar com Warrel. Sem meias palavras:


I disagree with the routine use of  "high-dosage cortisone" before antivenom. Early reactions occur in less than a quarter of the patients and so it seems unreasonable to expose all to the general dangers of corticosteroids and possibly to increased venom toxicity. Corticosteroids are not always successful in preventing early serum reactions, but these reactions can be safely and effectively treated with adrenaline, 0 5 ml of 0 1°% solution by subcutaneous injection. The incidence of reactions due to anticomplementary activity may be reduced by diluting the antivenom and by giving it by slow intravenous infusion.


 DAVID A WARRELL
 Radcliffe Infirmary,
 Oxford

Warrell, D A, et al, American Journal of Tropical
 Medicine and Hygiene, 1976, 25, 517.

Warrell, D A, et al, British Medical Journal, 1975,
 4, 697.

Theakston, R D G, and Reid, H A, Lancet, 1976,
 2, 121.

Warrell, D A, and Ormerod, L D, American_Journal of
Tropical Medicine and Hygiene, 1976, 25, 525.

http://lachesisbrasil.blogspot.com/2011/05/acidente-laquetico-na-pratica.html