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Clin Case Rep. 2013 Oct;1(1):7-15. doi: 10.1002/ccr3.3. Epub 2013 Jul 24.

Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation.

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Center for Exploration and Travel Health, California Academy of Sciences San Francisco, California, USA.
Department of Anesthesia, University of California San Francisco, California, USA.
U.S. State Department (Ret) Berkeley, California, USA.
Janelia Farm Research Campus Ashburn, Virginia, USA.


Neurotoxic snake envenomation can result in respiratory failure and death. Early treatment is considered important to survival. Inexpensive, heat-stable, needle-free, antiparalytics could facilitate early treatment of snakebite and save lives, but none have been developed. An experiment using aerosolized neostigmine to reverse paralysis suggests how early interventions could be developed.


Anticholinesterase; emergency medicine; neurotoxin; snakebite; toxicology

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