In treating a black widow bite, which option is NOT typically part of management?

• A. Fomepizole
• B. Antihypertensive therapy
• C. Arachno-Fab
• D. Vasopressor therapy

Answer: (A)

Fomepizole is not used in black widow envenomation because it specifically inhibits alcohol dehydrogenase to treat methanol or ethylene glycol poisoning, not spider venom. In treating a black widow bite, the focus is on neutralizing the venom and supporting the patient: using the antivenom arachno-Fab to counteract venom effects, providing analgesia and sedatives to control pain and muscle spasms, ensuring good hydration, and employing hemodynamic support such as vasopressors if blood pressure becomes unstable or antihypertensive therapy if severe hypertension develops. Because fomepizole targets a completely different toxin mechanism, it does not fit typical management and isn’t indicated here.