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Pharmacological approaches that slow lymphatic flow as a snakebite first aid
Dirk F van Helden1, Paul A Thomas2, Peter J Dosen3
1School of Biomedical Sciences & Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia ; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
Plos Neglected Tropical Diseases
|March 4, 2014
Summary
Topical agents like nifedipine and lignocaine significantly slow lymphatic flow and delay venom toxicity in snakebite models. These findings support their potential use as an adjunct to pressure bandaging with immobilization (PBI) for improved snakebite first aid.
Area of Science:
- Pharmacology
- Toxicology
- Emergency Medicine
Background:
- Snake venom toxins often enter circulation via the lymphatic system.
- Slowing lymphatic flow may prevent systemic toxicity from snakebites.
- Previous studies showed nitric oxide donors reduce lymph flow and delay venom effects.
Purpose of the Study:
- To investigate topical nifedipine and lignocaine as snakebite first aid.
- To assess their efficacy in inhibiting lymph flow and protecting against envenomation.
- To determine the relationship between venom dose and time to respiratory arrest.
Main Methods:
- Anesthetized rat model used to study topical agents.
- Lymphatic transit times measured using dye.
- Respiratory arrest time recorded after lethal Eastern brown snake venom (Ptx) injection.
Main Results:
- Nifedipine and lignocaine significantly increased lymph transit times (500% and 390%).
- These agents increased time to respiratory arrest by 60% and 40% respectively.
- A negative linear relationship was found between Ptx venom dose and time to respiratory arrest.
Conclusions:
- Topical agents inhibiting lymphatic flow show promise for snakebite first aid.
- Potential adjunct to pressure bandaging with immobilization (PBI), especially when PBI is incorrectly applied.
- Local anesthetics offer the added benefit of pain reduction in snakebite management.
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