centruroides immune F2 Iinjection

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centruroides (scorpion) immune F(ab’)2 (equine) Iinjection

(sen-troo-roy-dees im-myoon fab),


(trade name)


Therapeutic: antidotes
Pharmacologic: antivenom
Pregnancy Category: C


Treatment of clinically important signs of scorpion envenomation which may include loss of muscle control, roving/abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth and vomiting.


Binds/neutralizes venom toxins, promoting removal from target tissues and elimination.

Therapeutic effects

Resolution of symptoms of envenomation.


Absorption: IV administration results in complete bioavailability
Distribution: Unknown.
Metabolism and Excretion: Unk.
Half-life: 159 hr.

Time/action profile (resolution of systemic symptoms)

IVwithin 4 hrunknownunknown


Contraindicated in: No contraindications noted.
Use Cautiously in: Known allergies to horse protein (↑ risk of serious hypersensitivity reactions); sensitization may develop from previous treatment; Lactation:  Use cautiously, secretion into breast milk is not known; Obstetric: Use during pregnancy only if clearly needed.

Adverse Reactions/Side Effects

Central nervous system

  • fatigue
  • headache
  • lethargy

Ear, Eye, Nose, Throat

  • rhinorrhea


  • cough


  • nausea (most frequent)
  • vomiting (most frequent)
  • diarrhea


  • pruritus (most frequent)
  • rash (most frequent)


  • localized reactions (from cresol excipient)


  • generalized myalgias (from cresol excipient)
  • myalgia


  • severe hypersensitivity reactions including anaphylaxis
  • delayed hypersensitivity reactions including serum sickness
  • fever (most frequent)


Drug-Drug interaction

None noted.


Intravenous (Adults) 3 vials initially, followed by 1 vial every 30–60 min as needed


Lyophilized powder for injection (requires reconstitution) made from equine plasma: not more than 120 mg total proteint and not less than 150 LD50(mouse) neutralizing units/vial

Nursing implications

Nursing assessment

  • Assess for signs and symptoms of scorpion envenomation (loss of muscle control, roving/abnormal eye movements, slurred speech, respiratory distress, excessive salivation, frothing at the mouth and vomiting). Monitor patient during and for at least 60 min following infusion to determine resolution of symptoms.
  • Monitor for signs and symptoms of hypersensitivity reactions (rash, shortness of breath, swelling of lips, face, or throat). Patients allergic to horse protein are especially at risk. Have IV epinephrine, corticosteroids, and diphenhydramine available. If reactions occurs, discontinue infusion and treat symptoms.
  • Monitor patient for signs and symptoms of delayed reactions (rash, fever, myalgia, arthralgia) with follow up visits. Treat symptomatically.

Potential Nursing Diagnoses

Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Initiate treatment as soon as possible after scorpion sting.
  • Intermittent Infusion: Reconstitute 3 vials with 5 mL of 0.9% NaCl and swirl gently to mix. Diluent: Combine contents of 3 vials promptly and dilute further with 50 mL of 0.9% NaCl.Do not administer solutions that are discolored or contain particulate matter. Discard partially used vials. Store at room temperature; do not freeze.
  • Rate: Infuse over 10 min.
  • May infuse additional doses at 30–60 min intervals, 1 vial at a time.

Patient/Family Teaching

  • Explain purpose of medication to patient.
  • Instruct patient to notify health care professional or emergency department immediately if signs and symptoms of delayed reactions (rash, pruritus, joint pain, fever, lymphadenopathy, malaise) occur. May occur for up to 14 days following treatment.
  • Advise female patient to notify health care professional if pregnant or pregnancy is suspected, or if breastfeeding.

Evaluation/Desired Outcomes

  • Resolution of symptoms of scorpion sting.
References in periodicals archive ?
The antidote, Anascorp, was specifically approved for the treatment of stings by the Cen-truroid.
Researchers in Mexico developed Anascorp from horse plasma.
Selects Accredo Health Group to Distribute Anascorp for the Treatment of Centruroides Scorpion Sting Envenomation, issued 13-Sep-2011 by Medco Health Solutions, Inc.
RDT) announced today that its recently approved Anascorp (Centruroides (Scorpion) Immune F(ab')2 (Equine) Injection) is now available on the market through Accredo Health Group, Inc.
Accredo will offer specialty wholesale distribution services of Anascorp to hospitals and other appropriately licensed facilities.
We worked successfully with Accredo to distribute Anascorp during the clinical trial phase, and we are excited to expand our relationship now that Anascorp is available commercially.
Anascorp, an F(ab')2 antibody is used for the treatment of patients with clinical signs of scorpion envenomation from the Centruroides sculpturatus scorpion.
Anascorp is the only FDA-approved therapy for these envenomations.
The drug will be marketed under the name Anascorp in the United States.
Food and Drug Administration today approved Anascorp, the first specific treatment for a scorpion sting by Centruroides scorpions in the United States.
Anascorp may cause early or delayed allergic reactions in people sensitive to horse proteins.
The effectiveness of Anascorp was based on results from a randomized, double-blind, placebo-controlled trial of 15 children with neurological signs of scorpion stings.