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響尾蛇抗毒血清 / 多價蝮蛇抗毒血清

Pit Viper Antivenin

Antivenin (Crotalidae) Polyvalent

解毒劑 / 抗毒血清IVIM狗貓馬

別名: CroFab · Pit Viper Antivenin · Crotalidae Polyvalent Immune Fab

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

1-2 vials of antivenin. Initially, give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administer by slow IVIV· prn
100–250 ml — 每隻動物的固定劑量（不按體重換算）

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
Pit viper envenomation1-2 vials of antivenin. Initially, give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administer by slow IVIVprn—🌎 NA
Pit viper envenomation1-5 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/IMq2h as required—🌎 NA
  • Pit viper envenomation: Adjust infusion volume in smaller patients to prevent fluid overload. Intravascular bites or bites to torso/tongue require prompt, aggressive administration.
  • Pit viper envenomation: The smaller the victim, the larger the dose (venom amount/kg is higher).

貓

適應症劑量途徑頻次療程地區
Pit viper envenomation1-2 vials of antivenin. Initially, give one vial, by diluting to 100-250 mL of crystalloid fluids and initially administer by slow IVIVprn—🌎 NA
  • Pit viper envenomation: Adjust infusion volume in smaller patients to prevent fluid overload.

馬

適應症劑量途徑頻次療程地區
Systemic effects of envenomation1-2 vials slowly IV diluted in 250-500 mL saline or lactated Ringer'sIVprn—🌎 NA
  • Systemic effects of envenomation: Use only if necessary to treat systemic effects. Administer antihistamines; corticosteroids are contraindicated.

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

多價蝮蛇抗毒血清是一種關鍵且能挽救生命的​解毒劑​，用於治療北美、中美及南美洲蝮蛇（如響尾蛇、銅頭蛇、棉口蛇、三色矛頭蝮）的毒液咬傷。

  • ​劑型​：提供​馬來源​產品（完整IgG抗體）及​羊來源​產品（Fab片段，例如CroFab®）。
  • ​風險​：獸醫標籤的馬來源產品中高達50%含有馬白蛋白及其他蛋白質，具有顯著的過敏反應（過敏性休克）風險。
  • ​臨床要點​：雖然羊來源Fab產品（CroFab）為人類標籤，但在獸醫學中常被標示外使用。與完整IgG馬來源產品相比，Fab片段引發過敏性休克的風險通常較低，但其半衰期較短，可能需要重複給藥以防止毒性復發。
  • 治療需要積極的支持性護理，且費用通常非常高昂。

作用機制

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.

安全性與警告

禁忌症

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

不良反應

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

注意事項

High risk of anaphylaxis due to equine-origin proteins. A test dose (1:10 dilution intracutaneously) is sometimes suggested but evaluation is difficult. Slow IV administration is usually sufficient to identify reactive animals. Pre-treatment with diphenhydramine is highly recommended to sedate the patient and reduce allergic reactions. If an anaphylactoid reaction occurs (nausea, pruritus, pinna hyperemia), stop the infusion, administer additional diphenhydramine, and restart 5 minutes later at a slower rate.

藥物相互作用

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.

監測

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

過量

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.

可用產品

劑型

  • Powder for injection (lyophilized)

獸醫用

  • Antivenin (Crotalidae) Polyvalent Equine Origin single dose vial lyophilized; 10 mL vials with diluent (Antivenin - Fort Dodge)

人用標示

  • Antivenin (Crotalidae) Polyvalent Powder for Injection (lyophilized): combo packs with 1 mL vial of normal horse serum and 10 mL Bacteriostatic water (Wyeth)
  • Antivenin (Crotalidae) Polyvalent Immune Fab (Ovine Origin) Powder for Injection (lyophilized): 1 g total protein per single use vial (CroFab - Altana)

各地核准狀態

暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Do not store above 98°F (37°C); avoid freezing and excessive heat. Reconstitute gently by swirling (do not shake) to prevent foaming. Veterinary-labeled product should be used immediately after rehydration. Human equine product may be used within 4-48 hours depending on the reference. Ovine product (CroFab) should be refrigerated and used within 4 hours of reconstitution.

飼主須知

​醫療急症​：毒蛇咬傷是危及生命的急症。請立即尋求獸醫介入。

  • ​高昂費用​：抗毒血清治療非常昂貴。根據咬傷的嚴重程度和寵物的體型，可能需要多劑血清。
  • ​重症加護​：治療不僅僅是注射抗毒血清。您的寵物可能需要住院、積極的靜脈輸液治療、疼痛管理以及持續的監測。
  • ​過敏反應​：由於抗毒血清提取自馬或羊的蛋白質，在給藥期間有發生嚴重過敏反應（過敏性休克）的風險，或在數天至數週後發生延遲性反應（血清病）。您的獸醫將密切監測這些併發症。

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