Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation
Objective. Most snakebite deaths occur prior to hospital arrival; yet inexpensive, effective, and easy to administer out-of-hospital treatments do not exist. Acetylcholinesterase inhibitors can be therapeutic in neurotoxic envenomations when administered intravenously, but nasally delivered drugs co...
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ftdoajarticles:oai:doaj.org/article:9c5f5d0002284f22bcda2bdaa64f391b 2023-05-15T15:08:50+02:00 Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation Matthew R. Lewin Stephen P. Samuel David S. Wexler Philip Bickler Sakthivel Vaiyapuri Brett D. Mensh 2014-01-01T00:00:00Z https://doi.org/10.1155/2014/131835 https://doaj.org/article/9c5f5d0002284f22bcda2bdaa64f391b EN eng Hindawi Limited http://dx.doi.org/10.1155/2014/131835 https://doaj.org/toc/1687-9686 https://doaj.org/toc/1687-9694 1687-9686 1687-9694 doi:10.1155/2014/131835 https://doaj.org/article/9c5f5d0002284f22bcda2bdaa64f391b Journal of Tropical Medicine, Vol 2014 (2014) Arctic medicine. Tropical medicine RC955-962 article 2014 ftdoajarticles https://doi.org/10.1155/2014/131835 2022-12-31T04:47:53Z Objective. Most snakebite deaths occur prior to hospital arrival; yet inexpensive, effective, and easy to administer out-of-hospital treatments do not exist. Acetylcholinesterase inhibitors can be therapeutic in neurotoxic envenomations when administered intravenously, but nasally delivered drugs could facilitate prehospital therapy for these patients. We tested the feasibility of this idea in experimentally envenomed mice. Methods. Mice received intraperitoneal injections of Naja naja venom 2.5 to 10 times the estimated LD50 and then received 5 μL neostigmine (0.5 mg/mL) or 5 μL normal saline by nasal administration. Animals were observed up to 12 hours and survivors were euthanized. Results. 100% of control mice died. Untreated mice injected with 2.5× LD50 Naja naja died at average 193 minutes after injection, while 10 of 15 (67%) of treated mice survived and were behaviorally normal by 6 hours (P<0.02). In the 5× LD50 group, survival was prolonged from 45 minutes to 196 minutes (P=0.01) and for 10× LD50 mice, survival increased from 30 to 175 minutes (P<0.02). Conclusion. This pilot suggests that intranasal drugs can improve survival and is the first direct demonstration that such an approach is plausible, suggesting means by which treatment could be initiated before reaching the hospital. Further investigation of this approach to neurotoxic and other types of envenomation is warranted. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Indian Journal of Tropical Medicine 2014 1 6 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Matthew R. Lewin Stephen P. Samuel David S. Wexler Philip Bickler Sakthivel Vaiyapuri Brett D. Mensh Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 |
description |
Objective. Most snakebite deaths occur prior to hospital arrival; yet inexpensive, effective, and easy to administer out-of-hospital treatments do not exist. Acetylcholinesterase inhibitors can be therapeutic in neurotoxic envenomations when administered intravenously, but nasally delivered drugs could facilitate prehospital therapy for these patients. We tested the feasibility of this idea in experimentally envenomed mice. Methods. Mice received intraperitoneal injections of Naja naja venom 2.5 to 10 times the estimated LD50 and then received 5 μL neostigmine (0.5 mg/mL) or 5 μL normal saline by nasal administration. Animals were observed up to 12 hours and survivors were euthanized. Results. 100% of control mice died. Untreated mice injected with 2.5× LD50 Naja naja died at average 193 minutes after injection, while 10 of 15 (67%) of treated mice survived and were behaviorally normal by 6 hours (P<0.02). In the 5× LD50 group, survival was prolonged from 45 minutes to 196 minutes (P=0.01) and for 10× LD50 mice, survival increased from 30 to 175 minutes (P<0.02). Conclusion. This pilot suggests that intranasal drugs can improve survival and is the first direct demonstration that such an approach is plausible, suggesting means by which treatment could be initiated before reaching the hospital. Further investigation of this approach to neurotoxic and other types of envenomation is warranted. |
format |
Article in Journal/Newspaper |
author |
Matthew R. Lewin Stephen P. Samuel David S. Wexler Philip Bickler Sakthivel Vaiyapuri Brett D. Mensh |
author_facet |
Matthew R. Lewin Stephen P. Samuel David S. Wexler Philip Bickler Sakthivel Vaiyapuri Brett D. Mensh |
author_sort |
Matthew R. Lewin |
title |
Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
title_short |
Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
title_full |
Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
title_fullStr |
Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
title_full_unstemmed |
Early Treatment with Intranasal Neostigmine Reduces Mortality in a Mouse Model of Naja naja (Indian Cobra) Envenomation |
title_sort |
early treatment with intranasal neostigmine reduces mortality in a mouse model of naja naja (indian cobra) envenomation |
publisher |
Hindawi Limited |
publishDate |
2014 |
url |
https://doi.org/10.1155/2014/131835 https://doaj.org/article/9c5f5d0002284f22bcda2bdaa64f391b |
geographic |
Arctic Indian |
geographic_facet |
Arctic Indian |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Tropical Medicine, Vol 2014 (2014) |
op_relation |
http://dx.doi.org/10.1155/2014/131835 https://doaj.org/toc/1687-9686 https://doaj.org/toc/1687-9694 1687-9686 1687-9694 doi:10.1155/2014/131835 https://doaj.org/article/9c5f5d0002284f22bcda2bdaa64f391b |
op_doi |
https://doi.org/10.1155/2014/131835 |
container_title |
Journal of Tropical Medicine |
container_volume |
2014 |
container_start_page |
1 |
op_container_end_page |
6 |
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1766340117363949568 |