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crotalidae (pit viper) polyvalent antivenin (CroFab)

Indications: - pit viper envenomation, North & South American crotalids: rattlesnake, copperhead, cottonmouth, tropical moccasins, fer-delance, bushmaster Contraindications: - NOT effective against venom of coral snake pregnancy-category C safety in lactation ? Dosage: 1) IV administration 2) local injection not recommended 3) initial intradermal skin test prior to administration - 1 mL vial of equine serum for sensitivity testing comes with antivenin 4) dosage based upon clinical grading of envenomation a) Grade 0: no antivenin necessary b) Grade 1: 1-5 vials of antivenin c) Grade 2: 5-15 vials of antivenin d) Grade 3: 20+ vials of antivenin 5) additional infusions every 2 hours until signs & symptoms have resolved Pharmacokinetics: elimination: liver Adverse effects: 1) hypersensitivity with anaphylaxis may occur in as many as 25% of patients 2) serum sickness in 50-75% of patients - fever, malaise, arthralgias, lymphadenopathy, morbilliform rash in 7-14 days 3) peripheral neuritis (1-10%)

Related

crotalidae (pit viper) polyvalent antivenin (CroFab) Crotalidae (pit vipers) snakebite

Specific

agkistrodon piscivorus antivenin/crotalus adamanteus antivenin/crotalus atrox antivenin/crotalus scutulatus antivenin

General

antivenin

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Department of Veterans Affairs, VA National Formulary