Thanks Lorenzo.
What are your familiarities to such reactions and what are the symptoms to look at before it goes into a non totally re missive state in where it would be at the point of not being helped or saved?
The type of spider that bit him was a small black spider that jumps around.
Also what are symptoms to look for as far as a victim is concerned? does the spider die after attacking his prey?
Dear Priscilla,
I cannot make an exact prognosis as I do not know what species of spider attacked the individual nor do I know what previous medical condition, any medication that this patient was on prior to the incident of the spider bite.
We have to understand and take into consideration that drug interaction could play a role in the manifestation of side effects and symptoms, considering the notion of impeding with the drug metabolism in in the hepatocirculartory system or even extrahepatocellularly. (meaning in the liver or outside the liver---as we have Liver enzymes known as CYTOCHROME P450 isoenzymes, which are responsible for the metabolism of drugs, toxins etc; any alteration in the operation of these isonenzymes, can either increase the effect of drugs/toxins (in the case of inhibtion of the hepatometabolism, or the antithesis (opposite of which, in regards to the induction or overinduction of said enzymes).
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The patient that was bitten by the spider was injected with endotoxins from the spider, which will elicit an immediate humoral defense response (immune system response) from the body due to the fact that the toxins are foreign from the body.
What happens in this case is that the circulatory system will increase mast cell production, and with it the release of prostaglandin and bradykinin, as well as the release of mast cell's histamine. Histamine causes swelling, vasodilation,---which triggers for more wbc and macrophagial cellular systems to come to the area of infection and insidious onset to mitigate and contain the toxin.
Histamine can cause bronchoonstriction, which will lead to a difficulty in breathing, as it causes spastic contractions in the bronchioles, now if this man was an asthmatic patient, this would be an important contraindication. Difficulty of breathing would occur--and with that, a plethora of medical conditions correlated to that: dyspnea, nausea, vomitting, headhache, tremor, etc. etc.
The drug : "Celestamine" is nothing but an example of Anti-Histamine. Its a simple and a general subtype used here in the United States as well as in any country in the world with an established medical system. The PHilippines, being one of them.
The problem is not the drug, Priscilla, the problem is the pharmacokinetic and the pharmacodynamics that occurs when the drug is taken. If the patient was taking nitrates, if the patient was taking cimitedine or phenytoin or any other drugs that can inhibit or induce the CP450 isoenzymes, this would affect the metabolism of the said drug and other drugs that the patient was taking.
I don't know the patient and dont know his medical charts, but if he was an CHD patient, he would already be C/I (contraindicated) for the provision of "Celestamine" since it causes cardiotoxic efffects. Can cause tachyarrhthmia etc etc.
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I don't think the problem stems with the Philippine Doctor's incompetence, on the contrary, Filipino doctors are one of the Best of the Best here in the 'states.
The problem would probably lies on the fact that the Filipino doctors don't have full access to the patient's medical history, drug list, or the lot. SO their ability to prrescribe medication according to contraindications and medical diseases is hindered. The patient, who, am sure, went to the hospital, already in a shocked state, was not in the state of mind to provide his complete medical history, nor does hhe have the list with him, considering the fact that this bug bite situation was totally an assymetrical circumstance. It was probably not in his plans to get bitten by a spider in his trip to the philippines, and therefore nullify any subconscious notion of bringing his entire medical files from his physicians back in Europe.
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Right now, the best thing to do for this patient is to maintain in hospital care. So that the honored Nurses and Doctors in Bohol can monitor his situation, and provide the medical condition that is alloted in the Province of Bohol.
My Best,
Albrando Lorenzo Lucino Jr.
2nd Year M.D Student.
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Topic: Poisonous Spider in Tagbilaran Attacks Foreigner (Read 3191 times)