title: Failure of 3,4-diaminopyridine and edrophonium to produce significant clinical benefit in neurotoxicity following the bite of Papuan taipan (Oxyuranus scutellatus canni).
abstract: Progressive systemic neurotoxicity is a common feature in patients envenomed following the bite of a Papuan taipan (Oxyuranus scutellatus canni). Respiratory paralysis, which commonly results, accounts for considerable morbidity and mortality. Established neurotoxicity does not respond to antivenom. In this study, a combination of clinical and electrophysiological variables was used to assess the effect of edrophonium and 3,4-diaminopyridine in patients with significant neurotoxicity. Both drugs produced minor electrophysiological and clinical changes in envenomed patients. This effect was maximal when the 2 drugs were used in combination, but was insufficient to be of significant clinical benefit. Neither drug can be recommended for use in the management of Papuan taipan bite.
authors.affiliation: Department of Clinical Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
authors.forename: A J
authors.initials: AJ
authors.lastname: Trevett
authors.forename: D G
authors.initials: DG
authors.lastname: Lalloo
authors.forename: N C
authors.initials: NC
authors.lastname: Nwokolo
authors.forename: S
authors.initials: S
authors.lastname: Naraqi
authors.forename: I H
authors.initials: IH
authors.lastname: Kevau
authors.forename: R D
authors.initials: RD
authors.lastname: Theakston
authors.forename: D A
authors.initials: DA
authors.lastname: Warrell
mesh_terms: D015761:4-Aminopyridine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000200:Action Potentials; D000077770:Amifampridine; D000818:Animals; D000931:Antidotes / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D004338:Drug Combinations; D004491:Edrophonium / Q000627:therapeutic use*; D004546:Elapid Venoms / Q000506:poisoning*; D017815:Elapidae; D018737:Hand Strength; D006801:Humans; D012909:Snake Bites / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000931:Antidotes; D004338:Drug Combinations; D004546:Elapid Venoms; D004491:Edrophonium; D001285:Atropine; D015761:4-Aminopyridine; D000077770:Amifampridine