Anti Snake Venom

ANTI-SNAKE VENOM

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·       Antisnake venom (ASV), also known as antivenom, is a biological product used to treat venomous bites or stings.

·       It is the only specific treatment for envenomation, which can otherwise result in severe morbidity or mortality.

·       ASV is derived from the plasma of animals, typically horses, that have been immunized with snake venom.

Definition

·       Antisnake venom is a therapeutic agent that neutralizes the toxic effects of venom from a snake bite.

·       It consists of antibodies or antibody fragments that bind to and inactivate venom toxins, thereby preventing or reversing the harmful effects of envenomation.

Classification

1.     Monovalent ASV: Targets venom from a single snake species.

o   Example: Monovalent Cobra Antivenom for Naja naja (Indian cobra).

2.     Polyvalent ASV: Effective against venom from multiple snake species.

o   Example:

1.     Polyvalent Antivenom used in India for bites from four major species—

1.     Naja naja (Indian cobra),

2.     Bungarus caeruleus (common krait),

3.     Daboia russelii (Russell's viper), and

4.     Echis carinatus (saw-scaled viper).

Pharmacokinetics

·        Absorption: ASV is typically administered intravenously, ensuring rapid absorption into the bloodstream.

·        Distribution: Once in the bloodstream, the antibodies distribute throughout the body, binding to venom components.

·        Metabolism: ASV is metabolized primarily in the liver.

·        Excretion: The metabolites are excreted through the kidneys.

Mechanism of Action

·       The mechanism of action of ASV involves the binding of antibodies to specific venom toxins.

·       This binding neutralizes the toxins, preventing them from interacting with their targets in the body, such as nerve endings, muscle tissue, or blood cells.

·       The immune complex formed by the antibody-toxin binding is then removed by the body’s reticuloendothelial system.

Uses

·        Treatment of snake bites

o   ASV is used to treat systemic envenomation by venomous snakes.

o   The choice between monovalent and polyvalent ASV depends on the identification of the snake species.

·        Preventive use in high-risk areas

o   In certain cases, ASV may be administered prophylactically in high-risk regions where snake bites are common, although this is rare.

Adverse Effects

·        Allergic reactions: Anaphylaxis, urticaria, and serum sickness are common allergic reactions due to ASV administration.

·        Fever and chills: Some patients may experience fever, chills, or rigor after receiving ASV.

·        Hypotension: ASV can cause a drop in blood pressure in some patients.

·        Coagulopathy: Though rare, some patients may experience coagulation disorders as a reaction to ASV.

Contraindications

·        Known hypersensitivity: Patients with a known severe allergic reaction to animal proteins (e.g., horse serum) should avoid ASV unless the benefits outweigh the risks.

·        Pregnancy: While ASV can be administered during pregnancy, it should be done cautiously and only when absolutely necessary.

·        Autoimmune diseases: Caution is advised when administering ASV to patients with autoimmune diseases, as it may exacerbate their condition.

Role of Nurse

1.     Assessment: The nurse must assess the patient's condition, including vital signs, the severity of envenomation, and any history of allergies.

2.     Preparation and Administration: The nurse should prepare the ASV, ensuring it is the correct type and dosage. It should be administered intravenously, with the patient closely monitored for adverse reactions.

3.     Monitoring: Continuous monitoring of the patient's vital signs and symptoms is crucial, especially for signs of anaphylaxis or serum sickness.

4.     Education: Educating the patient and family about the importance of ASV, potential side effects, and the need for follow-up care is an essential role of the nurse.

5.     Supportive Care: The nurse should provide supportive care, such as administering antihistamines or corticosteroids in case of allergic reactions, and managing symptoms like pain, fever, or hypotension.

6.     Documentation: Accurate documentation of the administration, patient response, and any adverse effects is essential for ongoing care and future reference.

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