Veterinary Drug Handbook (VDH) is the reference veterinarians turn to when they want an independent source of information on the drugs that are used in veterinary medicine today.

ANTIVENIN (CROTALIDAE) POLYVALENT, ANTIVENIN (MICRURUS FULVIAS) CORAL SNAKE

NOTE: The location of antivenins for rare species and the telephone numbers for envenomation experts is available from the Arizona Poison Control Center: (602) 626-6061.
Chemistry - These products are concentrated serum globulins obtained from horses immunizedwith the venoms of several types of snakes. They are provided as refined, lyophilized product with asuitable diluent.

Storage, Stability, Compatibility

Do not store above 98°F (37°C). The coral snake productshould be stored in the refrigerator.

Pharmacology - ANTIVENIN (CROTALIDAE) POLYVALENT, ANTIVENIN (MICRURUS FULVIAS) CORAL SNAKE

Antivenins act by neutralizing the venoms (complex proteins) in patients viapassive immunization of globulins obtained from horses immunized with the venom.

Uses, Indications

These products are indicated for the treatment of envenomation from mostvenomous snakes found in North America (not Sonoran or Arizona Coral Snake) causing serioussystemic toxicity or potential serious toxicity in domestic animals. There is a fair amount of controversy with regard to these products' use in domestic animals. The risks of administration (e.g., anaphylaxis¯see below) may outweigh their potential benefits in certain circumstances. However, these agents can be life-saving when given early in select situations. Many factors contribute to thepotential for toxicity (victim's size and general health, bite site(s), number of bites, age, species and size of snake, etc.).
Antivenin can be very expensive. One 10 ml vial of Crotalidae antivenin approved for use in dogscosts approximately $100. The coral snake product (for human use) cost is >$150 per vial and totreat a coral snake bite may require 5 or more vials. Because of the high cost, not being returnablefor credit, and potential adverse effects, veterinary practices need to assess all factors beforestocking and using these products.
Contraindications/Precautions - The coral snake antivenin will not neutralize M euryxanthus(Sonoran or Arizona Coral Snake) venom. Because there is a risk of anaphylaxis occurring secondary to the horse serum, many recommend perform sensitivity testing before administration.

Adverse Effects, Warnings

The most significant adverse effect associated with the use of theseproducts is anaphylaxis secondary to the equine serum source of this product. A 1:10 dilution ofthe antivenin given intracutaneously at a dose of 0.02 - 0.03 ml may be useful as a test for hypersensitivity. Wheal formation and erythema indicate a positive reaction and are generally seen within30 minutes of administration. A negative response does not insure that anaphylaxis will not occurhowever.

Drug Interactions

Although reducing excessive movement and other supportive therapy areimportant parts of treating envenomation, drugs that can mask the clinical signs associated with thevenom (e.g., analgesics and sedatives) should be used with discretion. It has also been stated thatantihistamines (Controversial: See equine dose below) and tranquilizers are contraindicated as theymay potentiate the venom.
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