Snakebite treatment

The Indian folk medicine, called Ayurvedic medicine, can be traced back 3000-5000 years and was practiced by the Brahmin sages of ancient times. The treatments were set out in sacred writings called Vedas. The material medica are extensive and most are based on herbal formulations. Some of the herbs have appeared in Western medicines, such as cardamom and cinnamon. Susruta, a physician in the fourth century ad, described the use of henbane as antivenom for snakebites. 

In 1996, Ito et al. reported the isolation of clauszoline-A (167) and clauszoline-B (168) from the acetone extract of the stem bark of C. excavata collected in Singapore (74). These alkaloids represented the first, naturally occurring 2,8-dioxygenated-3-formylcarbazole alkaloids with a dimethylpyran ring fused to C-7 and C-8 of the carbazole nucleus. The extracts of the leaves and bark of this tree have been used in traditional medicine for the treatment of snakebites and abdominal pain (74). One year later, the same group isolated another pyrano[2,3-fl]carbazole alkaloid, clauszoline-H (169), from the roots of the same natural source in Japan (47) (Scheme 2.34). 

Worldwide, there are an estimated 300,000 to 400,000 venomous snakebites per year with about 10% (or 30 000) resulting in death. In the United States, there are approximately 7000 venomous bites per year but only 1 in 500 deaths, testifying to the value of prompt medical treatment. 

Schumanniophyton magnificum has been the source of most of the alkaloids so far isolated. It has several interesting uses in traditional medicine. In Cameroon the bark is used for dysentery as an enema (70). The phenolic compounds present may exert an astringent effect to account for this. In Nigeria the stem juice is used as a treatment for snakebite and the roots are used to treat madness. 

Mescaline is an alkaloid isolated from the peyote cactus, species Lophophora williamsii or Anhalonium lewinii, that grows in the southwestern United States and in Mexico. Mescaline is found in buttons that grow on top of the plant. Aztec and Native American Indians used the buttons in religious rites and for treatment of snakebite, flu, and arthritis. Some street names include bad seed, blue caps, cactus buttons, devils root, mesc, moon, peyote, shaman, and tops. 

A number of dimeric carbazole alkaloids have been isolated from various natural sources in recent years, which have been found to exhibit various biological activities including antitumor, anti-inflammatory, and cytotoxic activities. In 1996, clausenamine A was isolated from the stem and root bark of Clausena excavata, which is used in Chinese herbal medicine for detoxification treatment following poisonous snakebites. The first total synthesis of clau-... 

Antivenom treatment can be complicated by early reactions (anaphylaxis), pyrogenic reactions, or late reactions (serum sickness-type). The incidence and severity of early reactions is proportional to the dose of antivenom and the speed with which it enters the blood stream (1,2). These reactions usually develop within 10-180 minutes of starting antivenom therapy. The reported incidence of early reactions after intravenous antivenom in snakebite patients, which ranges from 43% (3) to 81% (4), appears to increase with the dose and decrease when refined antivenom is used and administration is by intramuscular rather than intravenous injection. Unless patients are watched carefully for 3 hours after treatment, mild reactions can be missed and deaths misattributed to the envenoming itself. In most cases symptoms are mild urticaria, nausea, vomiting, diarrhea, headache, and fever however, in up to 40% of cases severe systemic anaphylaxis develops, with bronchospasm, hypotension, or angioedema. However, deaths are rare (5). 

Venomous snakes and venom have always been of interest to biologists. Historically, snake venoms were viewed as a valuable aid and were frequently used in early medical therapies. Ancient Egyptian and Chinese physicians utilized snake venoms as treatment for a variety of ailments and diseases. For over a century, snake venom has been used to develop antivenoms to treat snakebite envenomation. Currently, there are over 30 facilities worldwide that produce 120 different commercially available antivenoms. These antivenoms include both monovalent forms (effective for a specific species) and polyvalent forms (generally effective for several species that occur... 

Teucrium riparium Hochst. umnunu (Lamiaceae) root bark infusion is used in the treatment of diarrhoea. The root bark contains alkaloids, flavonoids, polyphenols and tannins 15). The plant is also used for snakebites 28). 

Dart RC, Seifert SA, Boyer LV, et al. A randomized multicenter trial of Crotalidae polyvalent immune Fab (ovine) antivenom for the treatment for crotaline snakebite in the United States. Arch Intern Med 2001 161 2030-2036. 

A. albida rizhomes ailment for skin diseases treatment of dysentery, gastrointestinal colics and snakebites as an adjuvant 25,26,27... 

A. brevipes Guaco rhizomes treatment of arthritis, wounds, snakebites and toothache 31, 52... 

A. constricta Saragez aerial parts as antispasmodic, analgesic, anticancer, antimalarial and antiinflammatory as emmenagogue treatment of snakebites 35, 36, 37... 

A. grandiflora aerial parts as uterotonic, cytotoxic and antimicrobial treatment of snakebites as flies and maggots repellent 15... 

A. heterophylla Yellowmouth, Dutchman s pipe fruits, roots as expectorant, antitussive, antiasthmatic and analgesic treatment of snakebites 15... 

A. macrourci Mil hombers, Patito Coludo, Jarrinha, lsipomilhombres whole plant treatment of snakebites and rheumatism as circulatory stimulant, antiinflammatory, antiseptic and abortive 64... 

A. rodrigucSii Sangue-de-Cristo roots, aerial parts as abortifacient and antiinflammatory treatment of snakebites 77... 

A. tuberosa roots treatment of sore throat, venomous snakebites, and tuberculosis 78... 

A. zollingeriana Ma douling fruits, roots as expectorant, painkiller, antitussive, antiasthmatic, and analgesic, Treatment of snakebites 79... 

Snakebite Coral snake antivenin (equine) crotalid antivenin (equine) Treatment also need antitetanus therapy... 

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