Atropine use in Centruroides scorpion envenomation

Area of Science:

• Toxicology
• Emergency Medicine
• Clinical Pharmacology

Background:

• Systemic scorpion envenomation can cause hypersalivation and respiratory distress.
• Atropine is generally contraindicated for foreign scorpion stings due to potential cardiorespiratory toxicity.
• Centruroides sculpturatus envenomation rarely presents with serious adrenergic effects.

Observation:

• A retrospective review identified five cases of Grade IV Centruroides sculpturatus envenomation treated with atropine.
• The study was conducted at a poison control center in a scorpion-endemic region.
• No clinically significant adverse effects were observed following atropine administration.

Findings:

• Atropine administration in severe C. sculpturatus envenomation was not associated with adverse events.
• In three cases, atropine effectively resolved hypersalivation and respiratory distress.
• These interventions potentially obviated the need for more aggressive treatments.

Implications:

• Atropine may be a viable therapeutic option for managing hypersalivation and respiratory distress in severe C. sculpturatus envenomation.
• This finding challenges the broad contraindication of atropine in scorpion stings.
• Further research is warranted to confirm the safety and efficacy of atropine in C. sculpturatus envenomation.