centruroides (scorpion) immune F(ab')2 (equine) Iinjection
sen-troo-roy-dees im-myoon fab
Treatment of clinically important signs of scorpion envenomation which may include loss of muscle control, roving/abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth and vomiting.
Binds/neutralizes venom toxins, promoting removal from target tissues and elimination.
Resolution of symptoms of envenomation.
Absorption: IV administration results in complete bioavailability
Metabolism and Excretion: Unk.
Half-life: 159 hr.
TIME/ACTION PROFILE (resolution of systemic symptoms)
|IV||within 4 hr||unknown||unknown|
- No contraindications noted.
Use Cautiously in:
- Known allergies to horse protein (↑ risk of serious hypersensitivity reactions); sensitization may develop from previous treatment;
- Lactation: Use cautiously, secretion into breast milk is not known;
- OB: Use during pregnancy only if clearly needed.
Adverse Reactions/Side Effects
CNS: fatigue, headache, lethargy
GI: nausea, vomiting, diarrhea
Derm: pruritus, rash
Local: localized reactions (from cresol excipient)
MS: generalized myalgias (from cresol excipient), myalgia
Misc: severe hypersensitivity reactions including anaphylaxis, delayed hypersensitivity reactions including serum sickness, fever
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
IV: (Adults) 3 vials initially, followed by 1 vial every 30–60 min as needed.
Lyophilized powder for injection (requires reconstitution) made from equine plasma: not more than 120 mg total proteint and not less than 150 LD50 (mouse) neutralizing units/vial
- Assess for signs and symptoms of scorpion envenomation (loss of muscle control, roving/abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth and vomiting). Monitor patient during and for at least 60 min following infusion to determine resolution of symptoms.
- Monitor for signs and symptoms of hypersensitivity reactions (rash, shortness of breath, swelling of lips, face, or throat). Patients allergic to horse protein are especially at risk. Have IV epinephrine, corticosteroids, and diphenhydramine available. If reactions occurs, discontinue infusion and treat symptoms.
- Monitor patient for signs and symptoms of delayed reactions (rash, fever, myalgia, arthralgia) with follow up visits. Treat symptomatically.
- Deficient knowledge, related to medication regimen (Patient/Family/Teaching)
- Initiate treatment as soon as possible after scorpion sting.
- Intermittent Infusion: Reconstitute 3 vials with 5 mL of 0.9% NaCl and swirl gently to mix. Diluent: Combine contents of 3 vials promptly and dilute further with 50 mL of 0.9% NaCl.Do not administer solutions that are discolored or contain particulate matter. Discard partially used vials. Store at room temperature; do not freeze.
- Rate: Infuse over 10 min.
- May infuse additional doses at 30–60 min intervals, 1 vial at a time.
- Explain purpose of medication to patient.
- Instruct patient to notify health care professional or emergency department immediately if signs and symptoms of delayed reactions (rash, pruritus, joint pain, fever, lymphadenopathy, malaise) occur. May occur for up to 14 days following treatment.
- Advise female patient to notify health care professional if pregnant or pregnancy is suspected, or if breastfeeding.
Resolution of symptoms of scorpion sting.
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