From the Research
Antivenin should be administered as soon as possible after a viper bite, ideally within the first 4-6 hours, though it can still be effective when given within 24 hours of envenomation. The complete course of antivenin treatment depends on the severity of envenomation and the patient's response to treatment. Typically, an initial dose of 4-10 vials is administered intravenously over 1-2 hours, with additional doses given if symptoms persist or worsen. Treatment should continue until clinical improvement occurs, including cessation of progressive swelling, normalization of clotting parameters, and resolution of systemic symptoms.
Key Considerations
- Before administration, patients should be tested for hypersensitivity to antivenin, and emergency medications (epinephrine, antihistamines, corticosteroids) should be readily available to treat potential allergic reactions 1.
- Antivenin works by binding to and neutralizing venom components in the bloodstream, preventing further tissue damage and systemic effects.
- The specific antivenin used must match the snake species responsible for the bite, so accurate snake identification or regional polyvalent antivenoms are crucial for effective treatment.
Administration Details
- The dose and duration of antivenin administration may vary depending on the severity of envenomation and the patient's response to treatment, with some studies suggesting that 2-4 vials of antivenin may be sufficient to block systemic toxicity 2.
- Antivenin should be administered as early as possible to prevent systemic dysfunction, with one study demonstrating that early treatment (within 3-6 hours) can reduce the severity of renal damage 2.
Monitoring and Follow-up
- Patients should be closely monitored for signs of allergic reactions, serum sickness, and other adverse effects, with emergency medications readily available 3.
- Treatment should continue until clinical improvement occurs, including cessation of progressive swelling, normalization of clotting parameters, and resolution of systemic symptoms.