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Australian Snakebite and Treatment

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Clinical Toxinology in Australia, Europe, and Americas

Part of the book series: Toxinology ((TOXI))

Abstract

Life-supporting treatment may be required after envenomation by species of Australian snakes from terrestrial genera: Pseudonaja (Brown snakes), Notechis (Tiger snakes), Oxyuranus (Taipans), Acanthophis (Death Adders), Pseudechis (Black snakes), Austrelaps (Copperhead snakes), Hoplocephalus and by the species Tropidechis carinatus (Rough-scaled snake), Paroplocephalus atriceps (Lake Cronin snake), and most of the genera of sea snakes including Hydrophis, Aipysurus, Laticauda, and Microcephalophis. Envenomation causes paralysis, procoagulant coagulopathy or anticoagulant coagulopathy (both causing hemorrhage), and rhabdomyolysis with renal failure. Procoagulant coagulopathy may also cause acute cardiovascular collapse and microangiopathic hemolytic anemia. Lesser known species cause nonlife-threatening illness. Early administration of antivenom can neutralize toxins and halt but not reverse procoagulopathy and establish tissue damage such as destroyed nerve terminals and rhabdomyolysis, which mandate time and supportive medical therapy. The recommended antivenom dose for an envenomated snakebite victim is two vials but less or more may be required, preceded by low-dose subcutaneous adrenaline to prevent allergic reactions. The few toxins identified and purified include: presynaptic phospholipase A2 neurotoxins taipoxin (Taipan), notexin (Tiger snake), textilotoxin (Brown snake); serine proteinase prothrombin activators in Taipan, Tiger snake, Brown snake, Rough-scaled snake, and Stephen’s Banded snake venoms; blockers of cyclic nucleotide-gated ion channels (pseudechetoxin, pseudecin) in Black snake venom and a plasmin inhibitor in Brown snake venom.

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Authors and Affiliations

  1. Intensive Care Unit, The Royal Children’s Hospital, The University of Melbourne, Melbourne, VIC, Australia

    James Tibballs

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  1. James Tibballs
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Correspondence to James Tibballs .

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Editors and Affiliations

  1. University of Hawaii Cancer Center, and Department of Pathology, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA

    Carl-Wilhelm Vogel

  2. Department of Emergency Medicine New Mexico School of Medicine, New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA

    Steven A. Seifert

  3. Laboratory of Immunochemistry, Division of Development and Innovation Butantan Institute, São Paulo, São Paulo, Brazil

    Denise V. Tambourgi

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Tibballs, J. (2018). Australian Snakebite and Treatment. In: Vogel, CW., Seifert, S., Tambourgi, D. (eds) Clinical Toxinology in Australia, Europe, and Americas. Toxinology. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7438-3_79

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