Crotalidae envenomation

Snake bite (pit vipers) Antivenin (Crotalidae) polyvalent, equine The entire dose should be given within 4 hours after the bite by the IV or IM route (1 vial = 10 mL) Minimal envenomation 2-4 vials Moderate envenomation 5-9 vials Severe envenomation 10-15 vials Additional doses may be required. Neutralizes the venom of rattlesnakes, copperheads, cottonmouths, water moccasins, and tropical and Asiatic crotalids. Serum sickness occurs in almost all patients who receive > 7 vials. 

Antivenin (Crotalidae) polyvalent immune Fab, ovine An initial dose of 4-6 vials should be infused intravenously over 1 hour. The dose should be repeated if initial control is not achieved. After initial control, 2 vials should be given every 6 hours for up to 3 doses. For the management of minimal to moderate North American crotalid envenomation. 

Presynaptic snake neurotoxins endowed with PLA2 activity (SPANs) are major components of the venom of four families of venomous snakes (Crotalidae, Elapidae, Hydrophiidae, and Viperidae). These neurotoxins play a crucial role in envenomation of the prey (Harris 1997) by causing a persistent blockade of neurotransmitter release from nerve terminals with a peripheral paralysis very similar to that of botulism (Connolly et al. 1995 Gutidrrez et al. 2006 Kularatne 2002 Prasampun et al. 2005 Theakston et al. 1990 Trevett et al. 1995 Warrell et al. 1983). 

McKinney PE Out-of-hospital and interhospital management of crotaline snakebite. Ann Emerg Med 2001 37(2) 168-174. [PMID 11174235] (Review of prehospital and interhospital care.) Ruha AM et al Initial postmarketing experience with crotalidae polyvalent immune Fab for treatment of rattlesnake envenomation. Ann Emerg Med 2002 39(6) 609-615. [PMID ... 

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