Parallel infusion of hydrocortisone ± chlorpheniramine bolus injection to prevent acute adverse reactions to antivenom for snakebites

• Fremantle Hospital & Health Service, and Clinical Senior Lecturer in Emergency Medicine, University of Western Australia, Department of Emergency Medicine, Fremantle Hospital, Alma Street, Fremantle, WA 6160.

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• 1. Gawarammana IB, Kularatne SAM, Dissanayake WP, et al. Parallel infusion of hydrocortisone ± chlorpheniramine bolus injection to prevent acute adverse reactions to antivenom for snakebites. Med J Aust 2003; 180: 20-23.<eMJA full text>
• 2. Analyse-it for Microsoft Excel [computer program]. Version 1.61. Leeds, UK: Analyse-it Software Ltd, 2001.
• 3. Smith PL, Kagey-Sobotka A, Bleecker ER, et al. Physiologic manifestations of human anaphylaxis. J Clin Invest 1980; 66: 1072-1080.
• 4. Silverman HJ, Taylor WR, Smith PL, et al. Effects of antihistamines on the cardiopulmonary changes due to canine anaphylaxis. J Appl Physiol 1988; 64: 210-217.
• 5. Felix SB, Baumann G, Hashemi T, et al. Characterization of cardiovascular events mediated by platelet activating factor during systemic anaphylaxis. J Cardiovasc Pharmacol 1990; 15: 987-997.
• 6. Berchtold E, Maibach R, Muller U. Reduction of side effects from rush-immunotherapy with honey bee venom by pretreatment with terfenadine. Clin Exp Allergy 1992; 22: 59-65.
• 7. Brockow K, Kiehn M, Riethmuller C, et al. Efficacy of antihistamine pretreatment in the prevention of adverse reactions to Hymenoptera immunotherapy: a prospective, randomized, placebo-controlled trial. J Allergy Clin Immunol 1997; 100: 458-463.
• 8. Lin RY, Curry A, Pesola GR, et al. Improved outcomes in patients with acute allergic syndromes who are treated with combined H1 and H2 antagonists. Ann Emerg Med 2000; 36: 462-468.
• 9. Brown SGA, Blackman KE, Stenlake V, Heddle RJ. Insect sting anaphylaxis; prospective evaluation of treatment with intravenous adrenaline and volume resuscitation. Emerg Med J 2004; 21: 149-154.