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Antivenin (Crotalidae) Polyvalent
Pronunciation
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Stability
Usual Dosage
Administration
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(an tee VEN in (kroe TAL ih die) pol i VAY lent)

Generic Available

No


Synonyms
Crotaline Antivenin, Polyvalent; North and South American Antisnake-bite Serum; Pit Viper Antivenin; Snake (Pit Vipers) Antivenin

Pharmacological Index

Antivenin


Use

Neutralization of venoms of North and South American crotalids: rattlesnake, copperhead, cottonmouth, tropical moccasins, fer-de-lance, bushmaster


Pregnancy Risk Factor

C


Stability

Store in refrigerator, avoid temperatures >37°C; reconstituted solutions should be used within 48 hours


Usual Dosage

Initial intradermal sensitivity test. The entire initial dose of antivenin should be administered as soon as possible to be most effective (within 4 hours after the bite).

Additional doses of antivenin is based on clinical response to the initial dose. If swelling continues to progress, symptoms increase in severity, hypotension occurs, or decrease in hematocrit appears, an additional 10-50 mL should be administered.

For I.V. infusion: 1:1-1:10 dilution of reconstituted antivenin in normal saline or D5W should be prepared. Infuse the initial 5-10 mL of diluted antivenin over 3-5 minutes monitoring closely for signs of sensitivity reactions.


Administration

Antivenin may be given I.M. for minimal envenomation. I.V. administration of antivenin is preferred for moderate to severe envenomation or in the presence of shock; for I.V. infusion, prepare a 1:1 to 1:10 dilution of reconstituted antivenin in normal saline or D5W; infuse the initial 5-10 mL dilution over 3-5 minutes while carefully observing the patient for signs and symptoms of sensitivity reactions. If no reaction occurs, continue infusion at a safe I.V. fluid delivery rate.


Patient Information

Immediate sensitivity reactions occur within 30 minutes after administration; serum-sickness reaction may occur 5-24 days after a dose


Nursing Implications

Do not inject into a finger or toe; epinephrine should be available. Antivenin may be administered I.M. for minimal envenomation. I.V. administration of antivenin is preferred for moderate to severe envenomation or in the presence of shock; for I.V. infusion, prepare a 1:1 to 1:10 dilution of reconstituted antivenin in normal saline or D5W; infuse the initial 5-10 mL dilution over 3-5 minutes while carefully observing the patient for signs and symptoms of sensitivity reactions. If no reaction occurs, continue infusion at a safe I.V. fluid delivery rate.

Monitor vital signs, hematocrit


Dosage Forms

Injection: Lyophilized serum, diluent (10 mL); one vacuum vial to yield 10 mL of serum


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