سم الثعابين

السم والترياق

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بسم الله الرحمن الرحيم
سنكتب  الأول عن
Specific Antidotes
لبعض الأدوية والسموم

· Organophosphrous Insecticides____________________________Atropine
· Beta blockers __________________________________________Atropine
· Flurides and hydrofluoric acid__________________________Ca . gluconate
· Cyanide and its derivatives______________________________dium nitrite and sodium thiosulfate and others
· Digitalis ___________________________________________Digoxin specific antibody fragment (FAB)
· Arsenic , lead , gold , cupper , zinc , inorganic mercury ___________ chelating agent as EDTA , Penicillamine
· Methanol and Ethylene glycol____________________________Ethanol
· OPoids ____________________________________Naloxone ( Narcan) amp.
· Carbon monoxide (CO) ____________________________ Oxygen (O2)
· Anti-Muscarinic Druge ______________________________Neostigmine
· MAOIs , Clonidine , Ergotamine (all cause hypertension)___________ Phentolamine
· Oral anticoagulants as Warfarine__________________________ Vit K amp.(Phytomenandione).
· Heparine ___________________________________________Protami ne sulfate
· INH (Isoniazide) _____________________________________Pyridoxin (Vit B6)
· Malignant hyperthermia , Neurotropic malignant syndrome_______Dantrolen
· Thallium ( in Rodenticides)____________________________ Prussian Blue (potassium ferric hexacyanoferrate)
· Benzodiazepine as diazepam _____________________________ Flumazenil (Annexate amp.)
· Antifolates (Methotrexate – Trimethoprime)_________________ Leuvovorin
· Iron___________________________________Desferrioxa mine (Desferal vial)
· Drug induce movment disorder ___________________________Benztropine
· Paracetamol , chloroform , carbon tetrachloride _____________Acetyl cysteine

أما عن موضوع سم الثعابين http://searo.who.int/LinkFiles/SDE_mgmt_snake-bite.pdf . الرابط لكتاب يتكلم عن الثعابين وطبيعة سم الثعابين والأعراض و العلاج وأنواع الثعابين السامة . ملحوظة : الكتاب يحتوى على صور للثعابين قد لا يود البعض رؤيتها وهذا للتنبيه Guidelines Reprint of the 1999 edition written and edited for SEAMEOTROPMED – Regional Centre for Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Thailand. for the Clinical Management of Snake Bite in the South-East Asia Region الكتاب معتمد من WHO

هذا هو فهرس الكتاب للتعريف بمحتواه Preface .................................................. ............................................. v 1. Introduction .................................................. ................................ 1 1.1 Venomous snakes of South-East Asia .................................................. ... 1 1.2 Snake venoms .................................................. .................................... 8 1.3 How common are snake bites? .................................................. ........... 9 1.4 How do snake bites happen? .................................................. ............ 11 1.5 How can snake bites be avoided? .................................................. ..... 11 2. Symptoms and Signs of Snake Bite ............................................. 13 2.1 When venom has not been injected .................................................. . 13 2.2 When venom has been injected .................................................. ....... 13 2.3 Clinical pattern of envenoming by snakes in South-East Asia ................ 14 2.4 Clinical syndromes of snake bite in South-East Asia ............................. 18 2.5 Long term complications (sequelae) of snake bite ................................ 19 3. Symptoms and Signs of Cobra-spit Ophthalmia ........................ 21 4. Management of Snake Bites in South-East Asia .......................... 23 4.1 First aid treatment .................................................. ............................. 23 4.2 Transport to hospital .................................................. ......................... 26 4.3 Treatment in the dispensary or hospital ............................................... 26 4.4 Detailed clinical assessment and species diagnosis ............................... 27 4.5 Investigations/laboratory tests .................................................. ............ 30 4.6 Antivenom treatment .................................................. ........................ 32 4.7 Supportive/ancillary treatment .................................................. .......... 40 4.8 Treatment of the bitten part .................................................. .............. 46 4.9 Rehabilitation .................................................. ................................... 47 iv 5. Management of Cobra Spit Ophthalmia..................................... 49 6. Conclusions and Main Recommendations ................................. 51 7. Further Reading .................................................. ........................ 55 Annex 1. Algorithm: Antivenom treatment of snakebite cases .................................... 61 2. Algorithm: Differentiating major asian snake species by clincal symdrome .................................................. ..................... 62 3. Antivenoms for treatment of bites by South-East Asian snakes ...................... 63 4. Measurement of Central Venous Pressure .................................................. . 66 5. Measurement of intracompartmental pressure in tensely swollen snake-bitten limbs .................................................. ............ 67   ---------------------------- من الاخطاء الشائعة جدا بالنسبة لعضة الثعبان ان المسعف يمص الدم مكان العضة وهذا خطأ   خطير جدا لانك بهذا تساعد على انتشار السم   ـ