Indian red scorpion (Mesobuthus tamulus) envenomation causes a clinical syndrome characterised by a massive autonomic storm. The initial pharmacological management of hypertension and pulmonary oedema is:

• A Adrenaline (epinephrine) to stimulate beta-2 receptors and open airways
• B Atropine to counteract parasympathetic overstimulation
• C Prazosin (selective alpha-1 blocker) along with supportive care ✓
• D Calcium gluconate intravenously as the specific antidote

Explanation

Mesobuthus tamulus venom causes massive release of catecholamines and autonomic neurotransmitters, producing hypertension, tachycardia, pulmonary oedema, and cold extremities due to alpha-adrenergic vasospasm. Prazosin, a selective alpha-1 adrenergic blocker, is the drug of choice in Ismail's regime (widely used in Maharashtra/Tamil Nadu), reversing vasoconstriction, reducing afterload, and relieving pulmonary oedema. Adrenaline and atropine would worsen the catecholamine storm. Calcium gluconate is used for black widow spider (Latrodectus) envenomation, not scorpion.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.