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Anti - Venom
Anti – Venom
• Anti – Venom, also known as antivenin,
venom antiserum, and antivenom
immunoglobulin, is a specific treatment for
envenomation.
• It is composed of antibodies and used to
treat certain venomous bites and stings.
Venomous snake in India
• Indian Cobra
• Saw-Scaled Viper
• Russell's Viper
• Common Krait
Types of venom
• Neurotoxic
• Cytotoxic
• Hemotoxic
• Myotoxic
Neurotoxic Venom
• This type of venom attacks nervous system.
– This mainly includes fasciculins, dendrotoxins,
alpha Neurotoxin.
– Dendrotoxins are found in the venom of Black
Mamba snake,which interferes with voltage-gated
K+channels. Tubocurarine, cobrotoxin,
bungarotoxin block the acetylcholine receptor or
prevent the opening of ion channel. By blocking
signals from nerves to muscles these toxins cause
paralysis and possibly death.
• Example- Venom of Cobras, Kraits
Symptoms of neurotoxic venom
1. Respiratory arrests
2. Prolonged unconsciousness
3. Dizziness
4. Tunnel vision
Cytotoxic Venom
• Cytotoxins involve phospholipases,
cardiotoxins.
• Phospholipases helps to split cell membrane
and helps to digest and subdue prey.
• Causes localized symptoms, like blue black
spots on the site of bite due to limited blood
circulation.
– Example – Venom of Puff Adder (Bitis arietans)
Hemotoxic Venom
• These venoms causes hemolysis or induce
blood coagulation.
• It attacks cardiovascular system, circulatory
system and muscle tissues thus directly leading
to heart failure.
• Symptoms are:
– Lethargy
– Headache
– Nausea
– Vomiting
– Example- Venom of Crotalus (Rattle Snake)
Myotoxic Venom
• The venom contains peptides that destroy the
muscle fiber proteins and results in
myonecrosis.
– Example- the venom of Brazilian Lance head snake.
• Symptoms include-
– dry throat
– thirst
– muscular spasm
– drooping eyelids
– blackish brown urine discharge
Specific investigations
• The 20-min whole blood clotting test(20 WBCT)
• Enzyme linked immunosorbent assay(ELISA)
• Other nonspecific tests include
– Serum creatinine
– Creatinine phosphokinase (CPK)
– Prothrombin time (PT
– Fibrinogen and fibrin degradation products (fdps)
– Arterial blood gas
– Electrolyte determinations
– Electrocardiogram (ECG)
– Electroencephalogram (EEG
Anti-venom
• The only available treatment against snake
bite is the usage of anti-venom.
• The first anti-venom for snakes was
developed by Alberte Calmette against the
Indian cobra.
Milking of snake venom
• The Snake’s head is
grasped between the
index fingerand thumb
• Application of pressure
on snake’s jaw
• The fangs are pushed
through a
plastic/parafilm
Membrane
• The venom is squeezed
out and collected
Production of Anti – Venom
A mixture of venoms from different species of
venomous snakes are injected into the body of
horse or goat or sheep.
The blood with antibodies are collected.
Anti – Venom
Manufacturers of Snake Anti-
venom in India
• Serum Institute of India, Pune.
• Haffkine Institute, Mumbai
Antidotal therapy
• Administer antivenintherapy as soon as possible if
any signs of systemic involvement are present
because the antivenin may reverse coagulopathy.
• Furthermore, larger initial doses should be
considered if severe envenomation from multiple
bites is evident
• The dose of antivenom for children should not be
reduced since the amount of venom injected by the
snake is independent of the victim's size
• Before the antivenin is given, premedicate the
patient with an antihistamine, and continue the
antihistamine for 5 days to prevent anaphylaxis
• Administer corticosteroids if any history of
previous serum sickness or allergic reaction to the
antivenin is present or for administration of large
doses of antivenin
• Pregnancy is not a contraindication to giving
antivenin.
• Edrophonium, neostigmine, and atropine may be
given to temporarily reverse respiratory weakness
until antivenin is obtained, but it should not delay
necessary intubation.
Uses of Anti-venom
• Neurotoxins are used to treat brain injuries,
strokes.
• Hemotoxin are used to treat heart attacks and
blood disorders.
• Anti Cancer Activities: Snake venom also lowers
down the activity of cancer cell by apoptogenic
effect.
• Anticoagulant properties: Snake venom enzymes
remove fibrinogen from the circulation without
converting it to fibrin. Venoms with anticoagulant
properties are extensively studied for possible
medical applications.
Side effects of Anti-venom
• Anaphylactic reactions such as
– Difficulty in breathing
– Reddening of skin
– Swelling of eyes and face
– Fever
• Inflammation of joints.
• Enlargement of lymph glands.
Recommended dose of anti-snake
venom based on level of
envenomation
Level of envenomation Dose of anti - venoum
Mild envenomation 3-5 vials
Moderate 5-10 vials
Severe 10 -15 vials
• Infusion should be done after test dose.
• Watch reaction of anti-snake venom
• Clean the bite site with povidine iodine
Conclusion
• Snake Venom is the stuff of night mares for
some, the light at the end of the tunnel for
others. It is a killer as well as a savior.
References
• "North American Micrurus (Coral Snake Venoms)". Toxnet: Toxicology Data
Network. September 15, 2015. Retrieved October 31, 2019.
• Franklin, Deborah, "Potential Treatment For Snakebites Leads To A Paralyzing
Test Archived 2014-08-09 at the Wayback Machine", NPR.org, July 31, 2013.
• "Universal antidote for snakebite: Experimental trial represents promising step
Archived 2014-07-07 at the Wayback Machine", California Academy of Sciences
via Science Daily, May 28, 2014.
• Whyte, Ian (2012). "Antivenom update" (PDF). Australian Prescriber. 35 (5):
152–155. doi:10.18773/austprescr.2012.069.
• Isbister GK. (2002). "Failure of intramuscular antivenom in Redback spider
envenoming". Emerg Med. 14 (4): 436–9. doi:10.1046/j.1442-
2026.2002.00356.x. PMID 12534488.
• Bhaumik, Rahul (2018). "Colonial Encounter on Indian Snakes and their
Venoms: The Transmission and Transformation of Western Ophiological
Knowledge in British India, 1780s-1910s" (PDF). Indian Journal of History of
Science. 53 (4). doi:10.16943/ijhs/2018/v53i4/49536. ISSN 0019-5235.
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Anti - Venoum.pptx

  • 2. Anti – Venom • Anti – Venom, also known as antivenin, venom antiserum, and antivenom immunoglobulin, is a specific treatment for envenomation. • It is composed of antibodies and used to treat certain venomous bites and stings.
  • 3. Venomous snake in India • Indian Cobra • Saw-Scaled Viper • Russell's Viper • Common Krait
  • 4. Types of venom • Neurotoxic • Cytotoxic • Hemotoxic • Myotoxic
  • 5. Neurotoxic Venom • This type of venom attacks nervous system. – This mainly includes fasciculins, dendrotoxins, alpha Neurotoxin. – Dendrotoxins are found in the venom of Black Mamba snake,which interferes with voltage-gated K+channels. Tubocurarine, cobrotoxin, bungarotoxin block the acetylcholine receptor or prevent the opening of ion channel. By blocking signals from nerves to muscles these toxins cause paralysis and possibly death. • Example- Venom of Cobras, Kraits
  • 6.
  • 7. Symptoms of neurotoxic venom 1. Respiratory arrests 2. Prolonged unconsciousness 3. Dizziness 4. Tunnel vision
  • 8. Cytotoxic Venom • Cytotoxins involve phospholipases, cardiotoxins. • Phospholipases helps to split cell membrane and helps to digest and subdue prey. • Causes localized symptoms, like blue black spots on the site of bite due to limited blood circulation. – Example – Venom of Puff Adder (Bitis arietans)
  • 9.
  • 10. Hemotoxic Venom • These venoms causes hemolysis or induce blood coagulation. • It attacks cardiovascular system, circulatory system and muscle tissues thus directly leading to heart failure. • Symptoms are: – Lethargy – Headache – Nausea – Vomiting – Example- Venom of Crotalus (Rattle Snake)
  • 11. Myotoxic Venom • The venom contains peptides that destroy the muscle fiber proteins and results in myonecrosis. – Example- the venom of Brazilian Lance head snake. • Symptoms include- – dry throat – thirst – muscular spasm – drooping eyelids – blackish brown urine discharge
  • 12.
  • 13. Specific investigations • The 20-min whole blood clotting test(20 WBCT) • Enzyme linked immunosorbent assay(ELISA) • Other nonspecific tests include – Serum creatinine – Creatinine phosphokinase (CPK) – Prothrombin time (PT – Fibrinogen and fibrin degradation products (fdps) – Arterial blood gas – Electrolyte determinations – Electrocardiogram (ECG) – Electroencephalogram (EEG
  • 14. Anti-venom • The only available treatment against snake bite is the usage of anti-venom. • The first anti-venom for snakes was developed by Alberte Calmette against the Indian cobra.
  • 15. Milking of snake venom • The Snake’s head is grasped between the index fingerand thumb • Application of pressure on snake’s jaw • The fangs are pushed through a plastic/parafilm Membrane • The venom is squeezed out and collected
  • 16. Production of Anti – Venom A mixture of venoms from different species of venomous snakes are injected into the body of horse or goat or sheep. The blood with antibodies are collected. Anti – Venom
  • 17. Manufacturers of Snake Anti- venom in India • Serum Institute of India, Pune. • Haffkine Institute, Mumbai
  • 18. Antidotal therapy • Administer antivenintherapy as soon as possible if any signs of systemic involvement are present because the antivenin may reverse coagulopathy. • Furthermore, larger initial doses should be considered if severe envenomation from multiple bites is evident • The dose of antivenom for children should not be reduced since the amount of venom injected by the snake is independent of the victim's size • Before the antivenin is given, premedicate the patient with an antihistamine, and continue the antihistamine for 5 days to prevent anaphylaxis
  • 19. • Administer corticosteroids if any history of previous serum sickness or allergic reaction to the antivenin is present or for administration of large doses of antivenin • Pregnancy is not a contraindication to giving antivenin. • Edrophonium, neostigmine, and atropine may be given to temporarily reverse respiratory weakness until antivenin is obtained, but it should not delay necessary intubation.
  • 20. Uses of Anti-venom • Neurotoxins are used to treat brain injuries, strokes. • Hemotoxin are used to treat heart attacks and blood disorders. • Anti Cancer Activities: Snake venom also lowers down the activity of cancer cell by apoptogenic effect. • Anticoagulant properties: Snake venom enzymes remove fibrinogen from the circulation without converting it to fibrin. Venoms with anticoagulant properties are extensively studied for possible medical applications.
  • 21. Side effects of Anti-venom • Anaphylactic reactions such as – Difficulty in breathing – Reddening of skin – Swelling of eyes and face – Fever • Inflammation of joints. • Enlargement of lymph glands.
  • 22. Recommended dose of anti-snake venom based on level of envenomation Level of envenomation Dose of anti - venoum Mild envenomation 3-5 vials Moderate 5-10 vials Severe 10 -15 vials
  • 23. • Infusion should be done after test dose. • Watch reaction of anti-snake venom • Clean the bite site with povidine iodine
  • 24. Conclusion • Snake Venom is the stuff of night mares for some, the light at the end of the tunnel for others. It is a killer as well as a savior.
  • 25. References • "North American Micrurus (Coral Snake Venoms)". Toxnet: Toxicology Data Network. September 15, 2015. Retrieved October 31, 2019. • Franklin, Deborah, "Potential Treatment For Snakebites Leads To A Paralyzing Test Archived 2014-08-09 at the Wayback Machine", NPR.org, July 31, 2013. • "Universal antidote for snakebite: Experimental trial represents promising step Archived 2014-07-07 at the Wayback Machine", California Academy of Sciences via Science Daily, May 28, 2014. • Whyte, Ian (2012). "Antivenom update" (PDF). Australian Prescriber. 35 (5): 152–155. doi:10.18773/austprescr.2012.069. • Isbister GK. (2002). "Failure of intramuscular antivenom in Redback spider envenoming". Emerg Med. 14 (4): 436–9. doi:10.1046/j.1442- 2026.2002.00356.x. PMID 12534488. • Bhaumik, Rahul (2018). "Colonial Encounter on Indian Snakes and their Venoms: The Transmission and Transformation of Western Ophiological Knowledge in British India, 1780s-1910s" (PDF). Indian Journal of History of Science. 53 (4). doi:10.16943/ijhs/2018/v53i4/49536. ISSN 0019-5235.