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Clinical Uses of Snake Antivenoms

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Toxinology

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Abstract

Antivenom is the key treatment for venomous snakebites. It is produced by purification of polyclonal IgG from plasma of large animals pre-immunized by snake venom. Polyvalent antivenoms, which neutralize venoms from many species prevalent in the areas of uses, are preferred over monovalent antivenoms because the snake species are frequently unidentifiable in clinical practice. Antivenom therapy can promptly reverse snakebite-induced coagulopathy and limb edema, but muscular paralysis from presynaptic toxins, tissue necrosis, and renal failure resolve much more slowly, especially when antivenoms are given late after bites. Effective treatments of these latter complications remain to be determined. The anaphylaxis-like early adverse reaction is the major limitation of antivenom uses. It is unpredictable by the immediate hypersensitivity skin test, and therefore, every antivenom administration requires close observation. Highly purified caprylic acid-stabilized IgG antivenoms show significantly lower rates of reactions. Clinical judgments to give antivenom should be individualized weighing potential benefits versus risks of antivenoms for the snakes in specific regions. Due to the high cost of antivenom production, this therapy is usually lacking in developing countries where snakebites are very common. Strategies for the adequate supply of good quality antivenoms are strongly needed.

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  1. Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Prof. Ponlapat Rojnuckarin

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  1. Prof. Ponlapat Rojnuckarin
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Correspondence to Ponlapat Rojnuckarin .

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  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    P. Gopalakrishnakone

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Rojnuckarin, P. (2013). Clinical Uses of Snake Antivenoms. In: Gopalakrishnakone, P. (eds) Toxinology. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6288-6_24-1

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  • DOI: https://doi.org/10.1007/978-94-007-6288-6_24-1

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  • Online ISBN: 978-94-007-6288-6

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