1.
Anti - Venom

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.
Symptoms of neurotoxic venom
1. Respiratory arrests
2. Prolonged unconsciousness
3. Dizziness
4. Tunnel vision

7.
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)

8.
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)

9.
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

10.
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

11.
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.

12.
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

13.
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

14.
Manufacturers of Snake Anti-
venom in India
• Serum Institute of India, Pune.
• Haffkine Institute, Mumbai

15.
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

16.
• 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.

17.
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.

18.
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.

19.
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

20.
• Infusion should be done after test dose.
• Watch reaction of anti-snake venom
• Clean the bite site with povidine iodine

21.
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.

22.
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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