Dose Of Prazocin in Treatment of Scorpion Sting

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
What is the dose of Prazocin in the treatment of Scorpion sting?
Answer
Prazosin is a cellular and pharmacologic antidote to the actions of scorpion venom and it is also cardioprotective. Prazosin is available as scored 1 mg tablet. Sustained release tablets are not recommended in this condition. The dose recommended is 30 microgram/kg/dose. This is given as an immediate measure in all with evidence of autonomic storm. It should not be given as prophylaxis in children when pain is the only symptom. In case of vomiting, it can be administered through nasogastric tube. After giving prazosin, mother should be advised not to lift the child to prevent the effects of ?First dose phenomenon' due to prazosin. Oral hydration and milk feeds must be encouraged. If needed, intravenous maintenance fluids should be given to correct dehydration due to excessive sweating and vomiting. Prazosin can be given irrespective of blood pressure provided there is no hypovolemia. Blood pressure, pulse rate and respiration must be monitored every 30 minutes for 3 hours, every hour for next 6 hours and later every 4 hours till improvement. Prazosin should be repeated in the same dose at the end of 3 hours according to clinical response and later every 6 hours till extremities are warm, dry and peripheral veins are visible easily. The time lapse between the sting and administration of prazosin for symptoms of autonomic storm determines the outcome. Not more than four doses are usually required. Ref: Mahadevan S. Scorpion sting. Indian Pediatric 2000: 27; 504-514. Back to All Questions

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