A 3-year old female child sleeping in a thatched hut woke up in the middle of the night screaming. Her mother thought the child had a nightmare and tried to pacify her. After sometime she noticed that the child was sweating profusely and the hands becoming cold, child also vomited a couple of times. The mother immediately rushed the child to the emergency services. His pulse was 150/minute and his BP 90/60 mm Hg. The first line of treatment for this condition is-
Prazosin is a medication primarily used to treat high blood pressure, symptoms of an enlarged prostate, and posttraumatic stress disorder (PTSD).It is a less preferred treatment of high blood pressure.Other uses may include hea failure and Raynaud syndrome.It is taken by mouth Common side effects include dizziness, sleepiness, nausea, and hea palpitations.Serious side effects may include low blood pressure with standing and depression.Prazosin is an a1-blocker.It works to decrease blood pressure by dilating blood vessels and helps with an enlarged prostate by relaxing the outflow of the bladder. How it works in PTSD is not entirely clear. Prazosin is orally active and has a minimal effect on cardiac function due to its alpha-1 receptor selectivity. When prazosin is staed, however, hea rate and contractility go up in order to maintain the pre-treatment blood pressures because the body has reached homeostasis at its abnormally high blood pressure. The blood pressure lowering effect becomes apparent when prazosin is taken for longer periods of time. The hea rate and contractility go back down over time and blood pressure decreases. The antihypeensive characteristics of prazosin make it a second-line choice for the treatment of high blood pressure. Prazosin is also useful in treating urinary hesitancy associated with prostatic hyperplasia, blocking alpha-1 receptors, which control constriction of both the prostate and urethra. Although not a first line choice for either hypeension or prostatic hyperplasia, it is a choice for patients who present with both problems concomitantly. There is some evidence that this medication is effective in treating nightmares, based on mixed results in randomized controlled trials. Prazosin was, however, shown to be more effective when treating nightmares related to PTSD. The drug is usually recommended for severe stings from the Indian red scorpion Ref Davidson 23rd edition pg 300
Coicosteroids
Prazosin
Anti snake venom
IV bolus ofnormal saline
Miscellaneous