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Posted On : 15 Jul 2012

in snake bite in children...i want to know the doses of antisnake...and how it given_?
what the risk of anaphylaxis_?
can be given intramuscular or iv
can be given in iv drip_?
is it must to give anti tetanus_? and what the dose_?

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Answer 1

Most snakebites are innocuous and are delivered by nonpoisonous species. Treatment is based on the severity of envenomation. Mild envenomation is characterized by local pain, edema, no signs of systemic toxicity, and normal laboratory values. Moderate envenomation is characterized by severe local pain` edema larger than 12 inches surrounding the wound` and systemic toxicity including nausea, vomiting, and alterations in laboratory values {eg, decreased hematocrit or platelet count}. Severe envenomation is characterized by generalized petechiae, ecchymosis, blood-tinged sputum, hypotension, hypoperfusion, renal dysfunction, changes in prothrombin time and activated partial thromboplastin time, and other abnormal test results defining consumptive coagulopathy.
Two kinds of antivenin are available. One has been manufactured since 1956. It is derived from horse serum after the horse is injected with sublethal doses of snake venom. The antivenin is purified but still contains other serum proteins that can be immunogenic. The latest version, approved by the US Food and Drug Administration {FDA} Antigen-binding fragment antivenom {FabAV} in 2000, is a monovalent immunoglobulin fragment derived from sheep but purified to avoid other antigenic proteins. The old antivenin may still be available, but it is generally recommended to use the more specific and purified drug. Even with the newer agent, one must remember while the antivenin may be life saving, it also may lead to immediate hypersensitivity {anaphylaxis} and delayed hypersensitivity {serum sickness} reactions and must be used with caution. To achieve maximum efficacy, administer within 4-6 hours of bite.

Dosage:
Mild envenomation: None
Moderate envenomation: Initially 6-10 vials IV
Severe envenomation: May require More than 25 vials IV

Snakes do not harbor Clostridium tetani in their mouths, but bites may carry other bacteria, especially gram-negative species. Tetanus prophylaxis is recommended if the patient is not immunized.

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