A group of researchers has published an article in Clinical Case Reports describing successful reversal of induced paralysis in a human volunteer after administration of intranasal aerosolized neostigmine, an anticholinesterase. According to the article, IV administration of anticholinesterases is the first-line treatment for neurotoxic snakebite when antivenom is not available.
The article suggests that similar nasal sprays for use in the field could prevent deaths of patients who die from respiratory failure as the result of paralysis from snakebite before they can reach a hospital. The half-life of intranasally administered neostigmine is twice as long as that of the drug when administered by IV.
Intranasal neostigmine has shown promising results in the treatment of myasthenia gravis, the researchers note, which led to the idea of using it for neurotoxic snakebite.
The article concludes that “Intranasal or otherwise topically applied anticholinesterases such as neostigmine—and other candidate drugs or drug combinations—could be delivered without advanced technical skill. The importance of the global snakebite problem and the potential for an efficient, effective solution warrants systematic investigation of topically applied anticholinesterases and other drugs as a potential first-line, in-the-field treatment strategy.”
Read the Clinical Case Reports article.
