Aust Fam Physician
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Mortality secondary to insect sting anaphylaxis, though uncommon in this country, is a genuine risk to patients with venom hypersensitivity. A number of non specific and specific preventive measures are available to minimise this risk. They include proper patient counselling regarding sting avoidance and the use of self injectable adrenaline, as well as venom specific immunotherapy. ⋯ The most common causes of insect stings in Australia are bees and wasps. Insect sting reactions cover a spectrum of responses, from normal to anaphylactic. Immunotherapy is indicated in those patients who experience anaphylactic responses. The presence of venom specific IgE must be demonstrated before commencing immunotherapy. Venom sensitive patients should be educated in anaphylaxis first aid with adrenaline self injectable syringes.
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Many venomous marine creatures inhabit Australian waters, causing significant morbidity and occasional fatalities. No antivenom is available for most of these creatures. Little is known about the venom or syndromes produced by many of these creatures. ⋯ The information contained within this article is intended to provide the reader with an overview of some of the more common marine envenomations, and hopefully with the knowledge to effectively manage such problems.
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Australian snakes are among the most venomous in the world. Although usually obvious, the occurrence of snakebite is occasionally unrecognised by the patient and/or physician, resulting in delayed or inadequate treatment, or even in death. ⋯ A high index of suspicion should be maintained, particularly in rural areas and in patients unable to give a history. Investigations including creatine kinase, clotting profile and venom detection kit should be performed in cases of suspected snakebite. The choice of appropriate antivenom and its indications are discussed.
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The first non-chlorofluorocarbon containing (non-CFC) metered dose inhaler (MDI) (i.e. albuterol, Airomir, 3M) has been approved for marketing in over 35 countries. It is hoped by the year 2000 most MDIs will use non-CFC propellants. By the year 2005 it is likely that CFC containing MDIs will no longer be available in developed countries. This article looks at the basis for this change and how it may affect medical practice.