Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus)

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Abstract
Objective—The efficacy of nifedipine and prazosin in combination or alone in the management of cardiovascular manifestations caused to Mesobuthus tamulus poisoning was investigated. Design—Observation and study. Setting—Hospital at Mahad, Maharashtra, India. Subjects—62 patients who had been stung by a red scorpion were admitted from January to December 1990: 18 with hypertension, 15 with supraventricular tachycardia, 11 with pulmonary oedema, and 18 with local pain at the site of sting but no systemic involvement. Two patients with massive life-threatening pulmonary oedema were given intravenous sodium nitroprusside. Results—The combination of nifedipine and prazosin was more successful in preventing myocardial damage in 16 patients with hypertension than was nifedipine alone in two other patients with hypertension. Prazosin alone helped to alleviate the cardiovascular manifestations in eight patients with pulmonary oedema and 15 with supraventricular tachycardia. One patient with pulmonary oedema died and two recovered after they were given intravenous sodium nitroprusside. Conclusion—Nifedipine alone did not prevent myocardial damage unless the peripheral action of venom was blocked by prazosin.

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