Rattlesnakes, water moccasins, and copperheads are the more common species of concern in the United States.
Rattlesnakes, water moccasins, and copperheads are the more common species of concern in the United States. Snake venom contains both pro- and anticoagulant enzymes, in addition to neurotoxins that inhibit acetylcholine release.
Roughly 20% of venomous snakebites do not release venom and are considered "dry bites". Clinical features may include local tissue damage, coagulathies, cardiotoxicity, and neurotoxicity.
Patients who have a "dry bite" or minor swelling with no systemic or hematologic abnormalities do not require antivenom. Patients who have progression of swelling with systemic or hematologic changes require admission and antivenom.
There are two snake antivenoms available; CroFab and Anavip. Product may be dependent on institutional formulary. Both are venom-specific immunoglublin G that neutralizes venom toxins. With CroFab, it is dosed at 4 to 6 vials initially. Repeat 4 to 6 vials until control of envenomation has been controlled. Once controlled, 2 vials every 6 hours for 3 doses are recommended. Anavip is dosed at 10 vials initially, then PRN for envenomation control. Patients may receive 4 vials for any reemerging symptoms. Monitor for hypersensitivities and infusion related reactions. Check out another video on my page, share the #PHARMFAX with a friend, and I hope you learned something new.
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