Antivenom therapy: efficacy of premedication for the prevention of adverse reactions

Antivenoms or antitoxins have been effectively used for more than a century. During this time, these products have always proven to be highly effective in the treatment of infections and envenomations. However, antivenoms did not exhibit good safety results in their initial applications. After many improvements, antivenoms have substantially better safety profiles but still have some side effects. Due to the occurrence of adverse reactions, the practice of using premedication with the intent to decrease side effects has become accepted or mandatory in many countries. The drugs used for premedication belong to the histamine H1 antagonist, glucocorticoid and catecholamine groups. Currently, this practice is being questioned due to low or controversial efficacies in clinical assays. In this article, we discuss the causes of adverse reactions, the mechanisms of drugs that block the undesired effects and the results obtained in clinical trials. Although these three families of drugs could have positive effects on reducing adverse reactions, only adrenaline has demonstrated positive results in clinical assays.(AU)

As enfermeiras obstétrcias frente ao uso de tecnologias não invasivas de cuidado como estratégias na desmedicalização do parto / The obstetrician nurses and the use of non-aggressive care technology as strategy in the non-medication of the childbirth / Las enfermeras obstetrices frente al uso de tecnologías no agresivas de cuidado como estrategias en la no-medicación del parto

O presente trabalho apresenta o olhar de enfermeiras obstétricas sobre o processo de desmedicalização da assistência ao parto considerando o uso de tecnologias não invasivas de cuidado de enfermagem. Mostra uma concepção ecológica de parto que compreende o não invadir a natureza, portanto, o parto como um evento fisiológico, natural. Aponta esse raciocínio como sendo hoje absolutamente contrário ao pensamento mecanicista que deu origem à obstetricia médica. Apresenta e define tecnologias não invasivas de cuidado de enfermagem obstétrica. Conclui defendendo o emprego dessas tecnologias na assistência ao parto como alternativa segura e eficaz no processo de sua desmedicalização