살무사 다가 항독소

해독제 / 항독소

살무사 다가 항독소는 북미, 중미, 남미의 살무사과(예: 방울뱀, 살무사, 물살무사, 페르드랑스) 교상 치료에 사용되는 중요하고 생명을 구하는 **해독제**입니다. * **제형**: **말 유래** 제품(전체 IgG 항체) 및 **양 유래** 제품(Fab 단편, 예: CroFab®)으로 제공됩니다. * **위험성**: 동물용 말 유래 제품의 최대 50%는 말 알부민 및 기타 단백질을 포함하고 있어 과민 반응(아나필락시스)의 심각한 위험을 수반합니다. * **임상 요점**: 양 유래 Fab 제품(CroFab)은 인체용으로 허가되었으나 수의학에서 허가 외(off-label)로 자주 사용됩니다. Fab 단편은 전체 IgG 말 유래 제품에 비해 아나필락시스 위험이 일반적으로 낮지만, 반감기가 짧아 독성 재발을 막기 위해 반복 투여가 필요할 수 있습니다. * 치료에는 적극적인 보존적 치료가 필요하며 비용이 매우 많이 들 수 있습니다.

작용 기전: Antivenins provide **passive immunity** to the patient. * They contain concentrated serum globulins (or Fab fragments) obtained from animals (horses or sheep) hyperimmunized with pit viper venom. * **Mechanism**: The immunoglobulins directly bind to and neutralize the complex toxic proteins and enzymes present in the venom. * **Effect** → Rapidly reverses venom-related systemic signs and coagulation abnormalities. * *Note*: Venom-induced thrombocytopenia, particularly from Timber Rattlesnakes, may be resistant to antivenin treatment.

동물 종별 용량

Cats

Pit viper envenomation · 1-2 vials of antivenin. Initially, give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administer by slow IV · IV · prn · Adjust infusion volume in smaller patients to prevent fluid overload.

Horses

Systemic effects of envenomation · 1-2 vials slowly IV diluted in 250-500 mL saline or lactated Ringer's · IV · prn · Use only if necessary to treat systemic effects. Administer antihistamines; corticosteroids are contraindicated.

Dogs

Pit viper envenomation · 1-2 vials of antivenin. Initially, give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administer by slow IV · IV · prn · Adjust infusion volume in smaller patients to prevent fluid overload. Intravascular bites or bites to torso/tongue require prompt, aggressive administration.
Pit viper envenomation · 1-5 rehydrated vials (10-50 mL) IV depending on severity of symptoms, duration of time after the bite, snake size, patient size. Additional doses may be given every 2 hours as required. If unable to give IV, may administer IM as close to bite as practical. · IV/IM · q2h as required · The smaller the victim, the larger the dose (venom amount/kg is higher).

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IVIM

금기

Known severe hypersensitivity to equine or ovine proteins (relative contraindication in life-threatening envenomation)

이상반응

Anaphylaxis (Type I hypersensitivity)
Anaphylactoid reactions
Serum sickness (Type III hypersensitivity, delayed)
Nausea
Pruritus
Hyperemia of the inner pinna

약물 상호작용

Analgesics/Sedatives · May mask the clinical signs associated with the venom; use with caution initially.
Antihistamines · Theoretical risk of potentiating venom, though diphenhydramine is routinely and safely used by clinicians for pre-treatment.
Beta-blockers · May mask the early signs associated with anaphylaxis.
Corticosteroids · Generally out of favor for treating snakebite envenomation, but may be useful to treat secondary anaphylaxis. Contraindicated in horses per some references.
Heparin · Reportedly not effective in treating the thrombin-like enzymes found in rattlesnake venom.

모니터링

Signs associated with an allergic response (anaphylaxis, anaphylactoid-reactions, serum sickness)
CBC with platelets
Coagulation parameters
Biochemical profile
Hydration status
ECG

과용량

Specific overdose information is not provided, but fluid overload is a significant risk in smaller patients receiving large volumes of crystalloid fluids used to dilute the antivenin.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.