{ "schema_version": 1, "kind": "condition", "id": "scorpion-sting", "name": "Scorpion Sting (Envenomation)", "category": "acute", "sources": "Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928 · Scorpion antivenom versus antivenom plus prazosin, Sohag University Hospitals (PMC11827372) · Egyptian National Drug Formulary - Antimicrobial 2023 · MSF Essential Drugs 2024 - paracetamol (oral)", "review_status": "reviewed", "verified_against": "Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928 · MSF Essential Drugs 2024 - paracetamol (oral) · Egyptian National Drug Formulary - Antimicrobial 2023", "verified_date": "2026-08", "treatments": [ { "id": 1651, "generic": "No drug therapy in primary care (Emergency Referral)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Any systemic sign - drooling, blurred vision, darting tongue movements, nystagmus, thrashing limbs, an arched back, sweating, vomiting or a fast pulse - is grade 3 or worse. Transfer immediately to a hospital holding VACSERA polyvalent antiscorpion antivenom. Telephone ahead.", "adult_duration": "Immediate emergency transfer", "dose_source": "Scorpion Toxicity - StatPearls, NCBI Bookshelf NBK430928", "rationale": "The two dangerous species in Egypt are Leiurus quinquestriatus and Androctonus crassicauda. Grade 1 is pain and pins-and-needles at the site; grade 2 is that pain spreading up the limb; grade 3 adds cranial nerve or neuromuscular signs; grade 4 has both and brings hyperthermia, rhabdomyolysis, pulmonary oedema and multi-organ failure. The hospital treatment is VACSERA polyvalent antiscorpion antivenom - 1 mL intramuscularly, or 1 to 5 vials in 5% glucose by infusion depending on severity, reassessed every 4 to 6 hours - and Sohag adds oral prazosin 30 micrograms/kg per dose, maximum 1 mg, four doses six hours apart, patient supine for three hours after the first.", "cautions": [ "Grade 1 is pain and pins-and-needles at the sting site and nothing else. Once the tingling has spread up the limb it is grade 2 - keep the patient under observation, do not send them home.", "Antivenom is not a primary-care drug. Do not spend time trying to find it locally; the transfer is the treatment.", "Prazosin is a hospital drug here for one reason - the first dose drops the blood pressure, which is why the patient stays supine for three hours after it.", "Clean the sting site and check tetanus cover on every sting that broke the skin." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Send every stung child, whatever the grade looks like in the first hour. The same dose of venom into a small body is a higher dose, and the grade can climb while you are watching.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "scorpion-sting" }, { "id": 1652, "generic": "Paracetamol", "line": 1, "is_adjunct": true, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1000 mg every 6 hours as needed, maximum 4000 mg in 24 hours", "adult_duration": "1-2 days", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "A grade 1 sting in an adult - pain at the site, nothing systemic - is treated with analgesia and observation, and nothing else. Analgesia does not change the grade, so it never replaces the decision to transfer.", "cautions": [ "Do not exceed maximum daily dose (risk of severe hepatotoxicity).", "Check total daily dose from all paracetamol-containing combination products.", "Reduce the maximum to 3000 mg/day in an adult under 50 kg, malnourished, or with liver disease.", "500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "15 mg/kg per dose every 4-6 hours, maximum 60 mg/kg/day. Pain relief on the way to hospital, not a reason to keep the child in the clinic. Under 1 month: 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg/day (MSF Essential Drugs 2024).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 500, "high_mg": 500, "capped": true } ], "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "scorpion-sting" }, { "id": 1653, "generic": "Tetanus toxoid", "line": 1, "is_adjunct": true, "form": "injection", "strength_mg": null, "adult_dose": "0.5 mL IM single dose into deltoid muscle", "adult_duration": "single dose", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Wound cleaning and tetanus prophylaxis are part of the supportive care of any sting that broke the skin.", "cautions": [ "A sting is a puncture wound - treat it as tetanus-prone and give a booster if the last dose was more than 5 years ago.", "Thorough wound cleaning is mandatory." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children >= 2 months: 0.5 mL IM single dose (usually given as DTaP/Tdap)", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 months and over", "age_min_months": 2, "age_max_months": 216, "dose_text": "0.5 mL IM single dose (usually given as DTaP/Tdap)" } ], "peds_doses": null, "brands": [], "condition_id": "scorpion-sting" } ] }