A/ opioids relieve pain and benzo- diazepines ease muscle spasms in most patients with latrodectism-widespread, sustained spasms-resulting from envenomation by a black widow spider (strength of recommendation [SOR]: C, case series).Black widow-specific antivenin appears to shorten duration of symptoms and reduce hospitalization more than symptomatic treatment, but can cause allergic reactions, including anaphylaxis and death from acute and delayed serum reactions(SOR: C, case series).A similar antivenin against the redback spider, a close relative of the black widow, produces clinical effects that are equivalent whether they're given intravenously (producing measurable serum levels) or intramuscularly (producing no measurable serum levels) (SOR: B, randomized controlled trial [RCT]), raising the possibility that the antivenin might not be effective at all.Calcium gluconate appears ineffective for symptom relief (SOR: C, case series).
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