Antivenom Injection 10ml

Uses

• Treatment of snake bites.

How does

Antivenom works by binding to the snake venom and neutralizing its harmful effects on the body.

Side Effects

• Anaphylactic reaction
• Breathlessness
• Decreased blood pressure
• Joint pain
• Serum sickness
• Shock
• Hives

Immediate Actions and First Aid

Quick and positive measures should be taken to meet the emergency:

1. Do not try to catch or kill the snake without proper tools and avoid unnecessary exposure to the snake.
2. Remove the patient to a well-ventilated and quiet place and restrict their movement.
3. Reassure the patient to overcome fear.
4. Immobilize the bitten part by applying an immobilization bandage as done for a fracture and keep the bitten part below heart level.
5. Avoid ligation by applying tourniquets; however, if applied, it should be tied at a moderate distance above the bitten part to prevent the entry of venom into the circulation.
6. Immediately take the patient to the nearby medical center for treatment without loss of time.

Composition

Each vial contains a lyophilized preparation of Snake Venom Antiserum. After reconstitution, each ml of Snake Venom Antiserum neutralizes not less than:

• Cobra venom (Naja naja) 0.60 mg
• Common Krait venom (Bungarus caeruleus) 0.45 mg
• Russell's Viper venom (Vipera russelli) 0.60 mg
• Saw-Scaled Viper venom (Echis carinatus) 0.45 mg

Description

Antivenom lyophilized is a refined and concentrated preparation of serum globulins for intravenous administration, containing equine immunoglobulin fragments F(ab') 2, obtained from the plasma of healthy equines, hyperimmunized against venoms of the above species of snakes. It also contains the antimicrobial agent: cresol.

Pharmacology

Snake venom antiserum is a sterile preparation containing antitoxin globulins and their derivatives. It is the only specific treatment for venomous snake bites.

Dosage & Administration

Prompt administration of an adequate dose of Antiserum is paramount for neutralizing unbound circulating snake venom components for early response to treatment. Delays in administration may result in increased dose requirements and decreased effectiveness. Due to varying clinical signs caused by factors such as the type of snake, time of reporting after the bite, size of the snake, amount of venom injected, and regional variations in venom composition, no accurate dosage can be recommended.

Recommended Initial Dose:

• 5-10 vials of Snake venom antiserum by slow intravenous infusion either undiluted at a speed of not more than 2 ml per minute or after dilution with normal/glucose saline at a rate of 5-10 ml/kg body weight over one hour.
• Children should receive the same dose as adults.

Monitoring and Further Dosing:

• Constant monitoring of vital signs during the initial 1 hour is recommended.
• Further dosing depends on the extent of the reversal of coagulopathy confirmed after 6 hours of Antiserum administration by WBCT in hemotoxic bites or if symptoms persist or worsen or in respiratory failure in neurotoxic bites after 1 hour of Antiserum administration.
• If blood is still incoagulable or no signs of reversal of paralysis are seen, a further dose of 5 to 10 vials of Antiserum should be administered by slow IV route only.
• IM or local administration around the bite wound is not recommended.

In most cases of both neurotoxic and hemotoxic bites, a total dose of 15-20 vials is adequate unless a proven recurrence of envenomation is established. Further doses can be given as per the clinical condition of the patient.

Hypersensitivity Skin Test:

• Hypersensitivity skin tests have no predictability value and should not be used.

Interaction

Risk of increased severity of acute anaphylaxis when used with β-adrenergic blockers.

Contraindications

There are no known contraindications for the administration of Antivenom.

Pregnancy & Lactation

Considering the risk associated with snake bite envenomation, pregnancy is not a contraindication for the administration of Snake Venom Antiserum after the bite.

Precautions & Warnings

Proper precautions are necessary for persons with known hypersensitivity to the constituents of the product. Some doctors prefer to premedicate patients with Inj. Adrenaline 0.25 ml to prevent the possibility of adverse reactions. In hemotoxic bites, IM injections should be avoided until the correction of coagulopathy to avoid the formation of hematoma and oozing of blood. In patients with tourniquets, it should be released slowly only after the start of Antivenom administration.

Reconstitution

To reconstitute the Antivenom, transfer the content of the supplied diluent into the vial containing the lyophilized preparation. Mix the contents gently by swirling action and avoid vigorous shaking. Serum should be used as soon as possible after reconstitution.

Storage Conditions

Lyophilized Antivenom is stable at room temperature and does not require special storage facilities. Ideally, it should be stored in a cool and dark place and not exposed to excessive heat.