北米サンゴヘビ抗毒素
**北米サンゴヘビ抗毒素**は、**トウブサンゴヘビ**および**テキサスサンゴヘビ**の咬傷による毒素を中和するための特異的な解毒剤です。ソノラ/アリゾナサンゴヘビの毒は中和できません。サンゴヘビの毒は主に**神経毒性**を示し、臨床症状が遅れて現れることがあるため、咬傷が疑われる動物は24〜48時間の入院観察が推奨されます。
作用機序: Antivenins provide **passive immunity** by supplying pre-formed neutralizing antibodies (globulins) derived from horses hyperimmunized with coral snake venom. * **Mechanism:** The antibodies directly bind to the complex venom proteins (specifically **alpha-neurotoxins**) in the patient's bloodstream. * **Pathway:** Venom-antibody binding → prevents neurotoxins from attaching to **nicotinic acetylcholine receptors** at the neuromuscular junction → halts the progression of flaccid paralysis and respiratory depression. * Each vial neutralizes approximately 2 mg of *M. fulvius fulvius* venom.
動物種別の用量
- Coral Snake envenomation · 1-2 vials of antivenin. Initially give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administering by slow IV . In smaller patients, adjust infusion volume to prevent fluid overload. Give additional vials as indicated by the progression of the syndrome. · slow IV · Initially, then as indicated · Dose necessary is calculated relative to the amount of venom injected and the body mass of patient. Smaller patients may require higher doses.
- Coral Snake envenomation (systemic effects) · Administer 1-2 vials slowly IV diluted in 250-500 mL saline or lactated Ringer's. · IV · Once, use only if necessary · Use only if necessary to treat systemic effects, otherwise avoid use. Administer antihistamines; corticosteroids are contraindicated. May be used with Crotilidae antivenin.
- Coral Snake envenomation · 1-2 vials initially, and more in 4-6 hours if necessary · IV · initially, and more in 4-6 hours if necessary · Therapy is best started within 4 hours after envenomation. Supportive care includes broad-spectrum antibiotics, fluid therapy and mechanical ventilation if necessary. Corticosteroids are not recommended.
- Coral Snake envenomation · 1-2 vials of antivenin. Initially give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administering by slow IV . In smaller patients, adjust infusion volume to prevent fluid overload. Give additional vials as indicated by the progression of the syndrome. · slow IV · Initially, then as indicated · Dose necessary is calculated relative to the amount of venom injected and the body mass of patient. Smaller patients may require higher doses (as venom amount/kg body weight is higher).
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Envenomation by Sonoran or Arizona Coral Snake (Micruroides euryxanthus)
有害事象
- Hypersensitivity reactions
- Anaphylaxis (incidence <2%)
- Anaphylactoid reactions
- Serum sickness
- Erythema and wheal formation (at injection site during sensitivity testing)
薬物相互作用
- Analgesics / Sedatives · May mask the clinical signs associated with the venom; use initially with caution.
- Antihistamines · Theoretical potentiation of venom, though undocumented. Diphenhydramine is routinely used by clinicians for pretreatment.
- Beta-blockers · May mask the early signs associated with anaphylaxis.
- Corticosteroids · Contraindicated for the treatment of snakebite envenomation itself, but may be useful to treat secondary anaphylaxis.
モニタリング
- Signs associated with an allergic response to the antivenin (anaphylaxis, anaphylactoid-reactions, serum sickness)
- Cardiorespiratory monitoring
- Mechanical ventilation parameters (if necessary)
- Pulse oximetry
過量投与
Specific overdosage information is not provided, but in smaller patients, care must be taken to adjust the infusion volume of the crystalloid diluent to prevent **fluid overload**.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。