Safety of nonsteroidal anti-inflammatory drugs in copperhead snakebite patients

Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
Hoang X Pham, Michael E Mullins

Abstract

Introduction: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not. Methods: We conducted a retrospective chart review of patients who presented to our adult and pediatrics emergency department with copperhead snakebites. We recorded patient demographics, snake type, any NSAIDs given, any opioid analgesics given, any documented bleeding, and most abnormal laboratory values of coagulation. Results: There was no significant difference in most abnormal PTT, fibrinogen, platelet count, and serum creatinine values between copperhead snakebite patients who received NSAIDs and those who did not. Mean INR was lower (p = .011) and hematocrit was higher (p = .018) for NSAID-treated patients than for patients treated w...Continue Reading

References

Feb 5, 2011·BMC Emergency Medicine·Eric J LavonasUNKNOWN Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority
Sep 10, 2014·Annals of Emergency Medicine·Anah J AliMichael E Mullins
Oct 5, 2015·Wilderness & Environmental Medicine·Nicholas C KanaanScott A Weinstein
Dec 23, 2016·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·James B MowryJay L Schauben
Dec 30, 2016·MMWR. Morbidity and Mortality Weekly Report·Rose A RuddLawrence Scholl
Jan 12, 2017·Care Management Journals : Journal of Case Management ; the Journal of Long Term Home Health Care·Angela M Nonaka
Oct 5, 2017·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Anne-Michelle RuhaUNKNOWN ToxIC Snakebite Study Group

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Citations

Oct 12, 2018·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Eric J Lavonas, Charles J Gerardo
Jan 25, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Craig CocchioShari Clifton
Mar 29, 2020·Biomédica : revista del Instituto Nacional de Salud·Teddy Angarita-SierraAriadna Rodríguez-Vargas
Nov 5, 2020·The American Journal of Tropical Medicine and Hygiene·Po-Chun ChuangChao-Jui Li

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