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antivenom adverse reaction

María Herrera, Melvin Sánchez, Anderson Machado, Nils Ramírez, Mariángela Vargas, Mauren Villalta, Andrés Sánchez, Álvaro Segura, Aarón Gómez, Gabriela Solano, José María Gutiérrez, Guillermo León
Subcutaneous administration of a low dose of adrenaline is used to prevent the early adverse reactions (EARs) induced by snake antivenoms. We used a rabbit model to study the effect of premedication with adrenaline on the potential of antivenoms to exert therapeutic effects and to induce late adverse reactions. We found that premedication with adrenaline did not change the heart rate or blood pressure of normal rabbits, but reduced the rise in temperature in rabbits previously sensitized with antivenom. Pharmacokinetic studies suggest that premedication with adrenaline does not affect the ability of the antivenom to exert the initial control of envenomation nor the susceptibility of rabbits to develop recurrence of antigenemia and envenomation...
April 15, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Thomas Lamb, Luc de Haro, Davide Lonati, Miran Brvar, Michael Eddleston
BACKGROUND: European viper bite is relatively uncommon but can cause serious envenoming, particularly swelling and hemorrhage spreading from limb to trunk that can cause long term disability. Systemic features are relatively mild compared to many other venomous species. Moderate-to-severe envenoming requires antivenom, which is given many hundreds of times each year across the continent. Several Vipera spp antivenoms are produced in Europe, but there is little comparative information available for the antivenoms and none is licensed with the European Medicines Agency...
March 28, 2017: Clinical Toxicology
M A Faiz, M F Ahsan, A Ghose, M R Rahman, R Amin, M Hossain, M N Tareq, M A Jalil, U Kuch, R D G Theakston, D A Warrell, J B Harris
We describe 70 cases of monocled cobra (Naja kaouthia) bite admitted to Chittagong Medical College Hospital, Bangladesh. The biting snakes were identified by examining the dead snake and/or detecting N. kaouthia venom antigens in patients' serum. Bites were most common in the early morning and evening during the monsoon (May-July). Ligatures were routinely applied to the bitten limb before admission. Thirty-seven patients consulted traditional healers, most of whom made incisions around the bite site. Fifty-eight patients experienced severe neurotoxicity and most suffered swelling and pain of the bitten limb...
January 30, 2017: American Journal of Tropical Medicine and Hygiene
Dikla Pivko-Levy, Itamar Munchnak, Ayelet Rimon, Uri Balla, Dennis Scolnik, Christopher Hoyte, Yair Voliovitch, Miguel Glatstein
BACKGROUND: Antivenom has been successfully used to treat systemic and progressive, local manifestations of envenomation inflicted by Vipera (V.) palaestinae, the most common venomous snake in Israel. The objective of this study was to evaluate the fixed dose V. palaestinae monovalent (equine) immunoglobulin G antivenom used in two pediatric emergency departments. In particular, we wanted to assess the need for repeated antivenom administration and the rate of adverse antivenom effects in children...
April 2017: Clinical Toxicology
J C Menon, J K Joseph, M P Jose, B L Dhananjaya, O V Oommen
INTRODUCTION: Snakebite is an occupational hazard causing considerable morbidity and mortality worldwide, particularly so in tropical countries like India. OBJECTIVE: The aim of this study is to (i) review the demographic, clinical and laboratory findings in patients (1051) admitted with venomous snakebite (ii) to correlate mortality, morbidity and duration of hospital stay with clinical signs, symptoms and laboratory parameters. METHODS: A retrospective study of 1051 patients treated for snakebite over 10 years (2000 - 2009) in Little Flower Hospital, Angamaly, Kerala...
August 2016: Journal of the Association of Physicians of India
Senanayake A M Kularatne, Kosala Weerakoon, Anjana Silva, Kalana Maduwage, Chamara Walathara, Ishani Rathnayake, Senal Medagedara, Ranjith Paranagama, Suresh Mendis, P V R Kumarasiri
The prevention of adverse drug reactions to antivenom serum poses a formidable challenge in the management of snakebite. Hydrocortisone is being used concurrently with antivenom in order to prevent these adverse drug reactions without a proven benefit. However, all previous studies seemed to ignore the testing of effectiveness of hydrocortisone therapy during its pharmacological effects, which come hours later. On this principle, we aimed to test the effectiveness of intravenous hydrocortisone given 2 h or more prior to the commencement of antivenom therapy to reduce adverse drug reactions to antivenom...
September 15, 2016: Toxicon: Official Journal of the International Society on Toxinology
Muhammad Hamza, Maryam A Idris, Musa B Maiyaki, Mohammed Lamorde, Jean-Philippe Chippaux, David A Warrell, Andreas Kuznik, Abdulrazaq G Habib
BACKGROUND: Snakebite poisoning is a significant medical problem in agricultural societies in Sub Saharan Africa. Antivenom (AV) is the standard treatment, and we assessed the cost-effectiveness of making it available in 16 countries in West Africa. METHODS: We determined the cost-effectiveness of AV based on a decision-tree model from a public payer perspective. Specific AVs included in the model were Antivipmyn, FAV Afrique, EchiTab-G and EchiTab-Plus. We derived inputs from the literature which included: type of snakes causing bites (carpet viper (Echis species)/non-carpet viper), AV effectiveness against death, mortality without AV, probability of Early Adverse Reactions (EAR), likelihood of death from EAR, average age at envenomation in years, anticipated remaining life span and likelihood of amputation...
March 2016: PLoS Neglected Tropical Diseases
Inthanomchanh Vongphoumy, Phankham Chanthilat, Phongmany Vilayvong, Joerg Blessmann
Snakebites are a seriously neglected public health problem in Lao PDR. Community-based cross-sectional surveys in two districts of Savannakhet province in Southern Laos revealed an incidence of up to 1105 snakebites per 100,000 persons per year. In contrast the number of snakebite patients treated in district and provincial hospitals are low. In order to improve health care for snakebite victims, antivenom was introduced to Savannakhet provincial hospital in July 2013 and medical staff has been trained in management of venomous snakebites at the same time...
July 2016: Toxicon: Official Journal of the International Society on Toxinology
Kishour Kumar Digra, Aakash Pandita, G S Saini, Rajni Bharti
AIM: To study the pattern of various adverse drug reactions (ADRs) occurring in children attending the Department of Pediatrics, SMGS Hospital, Jammu over 1 year. SUBJECTS AND METHODS: This was a prospective study, with study population of patients attending Department of Pediatrics over a period of 1 year. A structured format was used to enroll the participants. A pilot study was conducted to test the suitability of the format and feasibility of the study. The study was carried out to review various pattern of ADRs by using the Naranjo probability scale, and severity was assessed by using the Hartwig severity scale...
2015: Clinical Medicine Insights. Pediatrics
H Asita de Silva, Nicole M Ryan, H Janaka de Silva
Antivenom is the mainstay of treatment of snakebite envenoming. However, adverse reactions to snake antivenom that is available are common in many parts of the world where snakebite is prevalent. Both acute (anaphylactic or pyrogenic) and delayed (serum sickness type) reactions occur. Acute reactions are usually mild but severe systemic anaphylaxis may develop, often within an hour or so of exposure to antivenom. Serum sickness after antivenom has a delayed onset between 5 and 14 days after its administration...
March 2016: British Journal of Clinical Pharmacology
Norhan S Sheraba, Mohamed R Diab, Aymen S Yassin, Magdy A Amin, Hamdallah H Zedan
UNLABELLED: Snake bites represent a serious public health problem, particularly in rural areas worldwide. Antitoxic sera preparations are antibodies from immunized animals and are considered to be the only treatment option. The purification of antivenom antibodies should aim at obtaining products of consistent quality, safety, efficacy, and adherence to good manufacturing practice principles. Endotoxins are an integral component of the outer cell surface of Gram-negative bacteria. They are common contaminates of the raw materials and processing equipment used in the manufacturing of antivenoms...
July 2015: PDA Journal of Pharmaceutical Science and Technology
Toru Hifumi, Satoshi Fujimi, Takuya Yamagishi, Satoru Arai, Kyoko Sawabe, Akihiko Yamamoto, Manabu Ato, Keigo Shibayama, Akihiko Ginnaga, Nobuaki Kiriu, Hiroshi Kato, Yuichi Koido, Junichi Inoue, Masanobu Kishikawa, Yuko Abe, Kenya Kawakita, Masanobu Hagiike, Yasuhiro Kuroda
BACKGROUND: Redback spiders (Latrodectus hasselti) (RBSs) are venomous spiders that have recently spread to Asia from Australia. Since the first case report in 1997 (Osaka), RBS bites have been a clinical and administrative issue in Japan; however, the clinical characteristics and effective treatment of RBS bites, particularly outside Australia remains unclear. This study aimed to elucidate the clinical characteristics of RBS bites and to clarify the effectiveness of the administration of antivenom for treatment...
2014: Journal of Intensive Care
Abdulrazaq G Habib, Mohammed Lamorde, Mahmood M Dalhat, Zaiyad G Habib, Andreas Kuznik
BACKGROUND: Snakebite envenoming is a major public health problem throughout the rural tropics. Antivenom is effective in reducing mortality and remains the mainstay of therapy. This study aimed to determine the cost-effectiveness of using effective antivenoms for Snakebite envenoming in Nigeria. METHODOLOGY: Economic analysis was conducted from a public healthcare system perspective. Estimates of model inputs were obtained from the literature. Incremental Cost Effectiveness Ratios (ICERs) were quantified as deaths and Disability-Adjusted-Life-Years (DALY) averted from antivenom therapy...
January 2015: PLoS Neglected Tropical Diseases
Sean P Bush, Anne-Michelle Ruha, Steven A Seifert, David L Morgan, Brandon J Lewis, Thomas C Arnold, Richard F Clark, William J Meggs, Eric A Toschlog, Stephen W Borron, Gary R Figge, Dawn R Sollee, Farshad M Shirazi, Robert Wolk, Ives de Chazal, Dan Quan, Walter García-Ubbelohde, Alejandro Alagón, Richard D Gerkin, Leslie V Boyer
BACKGROUND: Crotalidae Polyvalent Immune Fab (Ovine) has been the only antivenom commercially available in the US since 2007 for treatment of Crotalinae envenomation. Late coagulopathy can occur or recur after clearance of Fab antivenom, often after hospital discharge, lasting in some cases more than 2 weeks. There have been serious, even fatal, bleeding complications associated with recurrence phenomena. Frequent follow-up is required, and additional intervention or hospitalization is often necessary...
January 2015: Clinical Toxicology
Maryjoy R Lepak, Samantha H Bochenek, Sean P Bush
OBJECTIVE: To present the case of a severe anaphylactic/anaphylactoid reaction to Crotalidae Polyvalent Immune Fab (Ovine) in a patient bitten by a copperhead snake. CASE SUMMARY: A 68-year-old man presented with progressive envenomation after receiving a copperhead snakebite on each hand. Crotalinae Fab antivenom was administered. While the initial and only dose was partially infusing, the patient developed an adverse drug reaction (ADR) of urticaria and hypotension, which resolved with cessation of the infusion, recurred with resumption of the infusion, and ultimately was completed with supportive care...
January 2015: Annals of Pharmacotherapy
Kalana Maduwage, Geoffrey K Isbister
Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC) is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang) snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom...
October 2014: PLoS Neglected Tropical Diseases
Sean H Rhyee, Lynn Farrugia, Timothy Wiegand, Eric A Smith, Paul M Wax, Jeffrey Brent
The Toxicology Investigators Consortium (ToxIC) Case Registry was established in 2010 by the American College of Medical Toxicology. The Registry includes all medical toxicology consultations performed at participating sites. This report summarizes the Registry data for 2013. A query of the ToxIC Registry was carried out for the dates of January 1 through December 31, 2013. Specific data reviewed for analysis included demographics (age, gender), source of consultation, reasons for consultation, agents involved in toxicological exposures, signs, symptoms and clinical findings, and treatment...
December 2014: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Geoffrey K Isbister, Colin B Page, Nicholas A Buckley, Daniel M Fatovich, Ovidiu Pascu, Stephen P J MacDonald, Leonie A Calver, Simon G A Brown
STUDY OBJECTIVE: Latrodectism is the most important spider envenomation syndrome worldwide. There remains considerable controversy over antivenom treatment. We aimed to investigate whether antivenom resulted in resolution of pain and systemic effects in patients with latrodectism who received standardized analgesia. METHODS: In a multicenter randomized placebo-controlled trial of redback spider antivenom for latrodectism, 224 patients (>7 years) with a redback spider bite and severe pain, with or without systemic effects, were randomized to receive normal saline solution (placebo) or antivenom after receiving standardized analgesia...
December 2014: Annals of Emergency Medicine
Najmeh Yardehnavi, Mahdi Behdani, Kamran Pooshang Bagheri, Amir Mahmoodzadeh, Hossein Khanahmad, Delavar Shahbazzadeh, Mahdi Habibi-Anbouhi, Gholamreza Hassanzadeh Ghassabeh, Serge Muyldermans
Hemiscorpius lepturus scorpionism poses one of the most dangerous health problems in many parts of the world. The common therapy consists of using antivenom antibody fragments derived from a polyclonal immune response raised in horses. However, this immunotherapy creates serious side effects, including anaphylactic shock sometimes even leading to death. Thus, many efforts have been made to introduce new replacement therapeutics that cause less adverse reactions. One of the most attractive approaches to replacing the available therapy is offered by single-domain antibody fragments, or nanobodies (Nbs)...
September 2014: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Urszula Czajka, Aldona Wiatrzyk, Anna Lutyńska
In the present paper, the actual knowledge on the composition and toxic properties of the European common viper venom was analyzed. The organism response to the particular components and the methods of neutralization of venom toxin in bitten person were presented. On the basis of literature data, the clinical course of envenomation with its classification according to the severity of symptoms was characterized. In the paper the situations in which administration of antivenom is required to neutralize toxic properties of venom and its possible adverse reactions were also described...
2013: Przegla̧d Epidemiologiczny
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