![]() ![]() Approximately 200 of the 3000 species of snake are known to be lethal. With few exceptions, notably Antarctica, Ireland, and New Zealand, snakes populate nearly every land mass in the world. Snakes produce some of the most varied neurotoxins in the animal kingdom. microlepidotus (Australian inland taipan), W. Species: Acanthophis species (death adder), Bungarus species (krait), Dendroaspis species (black/green mamba), Hydrophis species (sea snake), Micrurus species (coral snake), Naja species (cobra), Notechis species (tiger snake), O. Genus: Acanthophis, Aipysurus, Aspidelaps, Astrotia, Boulengerina, Bungarus, Dendroaspis, Elapsoidea, Enhydrina, Hemachatus, Homoroselaps, Hydrophis, Lapemis, Laticauda, Micropechis, Micrurus, Naja, Notechis, Ophiophagus, Oxyuranus, Pseudechis, Pseudonaja, Walterinnesia Skin testing for serum sickness reactions should be in accordance with package insert for the antivenin utilized.įamily: Elapidae (subfamilies Elapinae, and sea snakes Hydrophiinae and Laticaudinae) Hemodialysis may be needed to prevent renal failure associated with myotoxins. Antivenin premedication with steroids and diphenhydramine should be considered. This proprietary process purifies the final product by separating the antibody fragments and discarding those known to produce allergic responses and other side effects. Sheep-derived polyclonal antibodies are known to produce a reduced allergic response in humans. In 1998, CroTab, a sheep-derived Crotalidae polyclonal antibody, was developed. The possibility of anaphylaxis needs to be considered with all antivenins, and hence the urgency of the medication needs to be weighed against the need for skin testing. The antivenin is most effective when given within 4 hours after an envenomation. Intramuscular administration may be used, but the antivenin should be injected into a large muscle mass. Generally the IV route is preferred for antivenin administration. Structural similarities between the venoms of land and sea snakes enable the substitution of land snake antivenin for sea snake antivenin if the latter is not available. Sea snake monovalent antivenins are manufactured in Australia. Antivenins for Elapidae species are manufactured in South America and India. Both polyvalent Crotalidae antivenins and eastern coral snake monovalent antivenins are manufactured within the United States by Wyeth-Ayerst. ![]() The Florida Antivenin Bank makes antivenins available for emergency use through the Miami-Dade Fire Rescue Venom Response Unit (30). Immobilization of the envenomation site, inactivity, and hydration are important supportive measures. Snake toxins include neurotoxins, hemolytic toxins, and myotoxins. Most bites by sea snakes do not result in envenomation, particularly if a wetsuit is worn. In general, the apparatus for envenomation in sea snakes is less effective than that found among land snakes, but the toxins are much more potent. Watters M.D., in Current Therapy in Neurologic Disease (Seventh Edition), 2006 Snake Envenomations Recovery occurs within 1 week, but respiratory failure may cause death ( Reid, 1975a, b).Įlijah W. The myasthenic manifestations become superimposed on the myotoxic syndrome and produce ptosis, external opthalmoplegia, dysphagia, and even respiratory paralysis. The myotoxic activity causes myalgia and passage of dark urine indicating myoglobinuria. ![]() cyanocinctus and Microcephalophis gracifis gracilis are rich in 5′-nucleotidase and phospholipase A2 activity ( Alam et al., 1996 Tamiya et al., 1983). The erabutoxins a and b are the major neurotoxins in the venom of Laticauda semifasciatus ( Guinea et al., 1983 Tamiya and Arai., 1966). The important species include beaked sea snake ( Enhydrina schistose), blue spotted sea snake ( Hydrophis cyanocinctus), banded sea snake ( Hydrophis fasciatus atriceps), Hardwick’s sea snake ( Lapemis curtus), yellow-bellied sea snake ( Pelamis platurus), and sea krait ( Laticauda colubrine) ( Warrell, 2010b). The Hydrophiinae or true sea snakes comprise 16 genera and as many as 53 species whilst the partially terrestrial Laticauda or sea kraits comprise five species ( Lukoschek and Keogh, 2006). They are distributed in the Australasian region, across the Indian Ocean, and in the Western Pacific region. Sea snakes represent a diverse lineage of elapid snakes that have adopted a marine lifestyle. Kularatne, Nimal Senanayake, in Handbook of Clinical Neurology, 2014 Sea snakes ![]()
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