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Research Article

Low-Dose Adrenaline, Promethazine, and Hydrocortisone in the Prevention of Acute Adverse Reactions to Antivenom following Snakebite: A Randomised, Double-Blind, Placebo-Controlled Trial

  • H. Asita de Silva mail,

    asita@sltnet.lk

    Affiliation: Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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  • Arunasalam Pathmeswaran,

    Affiliation: Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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  • Channa D. Ranasinha,

    Affiliation: Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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  • Shaluka Jayamanne,

    Affiliation: Polonnaruwa General Hospital, Polonnaruwa, Sri Lanka

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  • Senarath B. Samarakoon,

    Affiliation: Polonnaruwa General Hospital, Polonnaruwa, Sri Lanka

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  • Ariyasena Hittharage,

    Affiliation: Kurunegala Teaching Hospital, Kurunegala, Sri Lanka

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  • Ranjith Kalupahana,

    Affiliation: Kurunegala Teaching Hospital, Kurunegala, Sri Lanka

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  • G. Asoka Ratnatilaka,

    Affiliation: Kurunegala Teaching Hospital, Kurunegala, Sri Lanka

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  • Wimalasiri Uluwatthage,

    Affiliation: Hambantota General Hospital, Hambantota, Sri Lanka

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  • Jeffrey K. Aronson,

    Affiliation: Department of Primary Health Care, University of Oxford, Oxford, United Kingdom

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  • Jane M. Armitage,

    Affiliation: Clinical Trial Service Unit, University of Oxford, Oxford, United Kingdom

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  • David G. Lalloo,

    Affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom

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  • H. Janaka de Silva

    Affiliation: Clinical Trials Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

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  • Published: May 10, 2011
  • DOI: 10.1371/journal.pmed.1000435

Reader Comments (1)

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Prevention of reactions with agents other than antivenom

Posted by sjaysinghe on 13 May 2011 at 07:31 GMT

This is an excellent study and the authors should be congratulated for doing it in a research setting in Sri Lanka.
I see an immediate relevance of these findings in other clinical situations.
The paper focuses primarily on anti-snake venom. In clinical practice, there are numerous instances where allergies are die to a similar pathway (i.e. IgE mediated). Examples include drug allergies and reactions to transfusions. Therefore, these findings could be extrapolated and used in other instances too: For example, blood transfusion in persons with a a past history of allergic reactions. Or, when giving IV antibiotics to persons with a history of drug allergies.

No competing interests declared.