A-conotoxin blocks the nicotinic acetylcholine receptor. Sleeper peptide is found primarily in C geographus . It induces a deep sleep state in test animals. Minor stings are characterized by local paresthesias and ischemia. Serious envenomations may result in paralysis and respiratory failure.
Death is typically secondary to cardiac failure.
C geographus may produce rapid cerebral edema, coma, respiratory arrest, and cardiac failure. 2-3 weeks of symptoms may be associated with more severe exposures. A victim of a cone shell envenomation may manifest an array of symptoms. Draw blood for complete blood count, electrolytes, and coagulation studies if indicated. Measure arterial blood gases.