McKenna's Drug Handbook for Nursing & Midwifery, 7e

1290      Miscellaneous drug categories

Adverse reactions CNS: headache. GI: abdominal pain, diarrhoea, nausea, vomiting. Skin: injection site reaction, urticaria, rash. Musculoskeletal: chest pain, myalgia. Other: allergic reactions, anaphylaxis , delayed serum sickness , chills, pyrexia. Interactions None reported. Contraindications Should not be used unless there is evidence of systemic envenoming with potential for serious toxic effects. care considerations • Death adder venom contains neurotoxins that induce paralysis. • As product is sourced from horse plasma, potential for transmission of infectious disease cannot be ruled out. • Not administered by IM injection. • Venom detection kits should be used to detect and identify specific venom at the bite site or in urine where possible. • Anaphylactic reactions may be more likely in individuals who are atopic or have previously received equine serum. • Although considered controversial, indi­ viduals at risk of anaphylactic reactions may be givenpremedicationwith adrenaline and antihistamine. • Have adrenaline 1:1000 available in case of anaphylactic reaction. • Severe cases should be managed in intensive care unit. • Monitor for delayed serum sickness within 8–13 days after the administration of antivenom, manifested by albuminaemia, arthralgia, fever, lymphadenopathy and skin eruptions. • Monitor the person closely after admin­ istering antivenom.

• Monitor for delayed serum sickness within 8–13 days after the administration of antivenom, manifestedby albuminaemia, arthralgia, fever, lymphadenopathy and skin eruptions. • Monitor the person closely after admin­ istering antivenom. Patient teaching • Advise person of risk of possible infectious disease transmission as venom is sourced from horse serum. • Instruct person to report any adverse effects—such as shortness of breath, itching, skin swelling, fever or chest pain— immediately. death adder antivenom Death Adder Antivenom Concentrate for Infusion Pregnancy risk category NR Use in sport: Permitted Available form Solution for infusion: 6000 U/vial Indications & dosages ➤ Treatment of systemic envenoming from deathadderbite— Adults: 6000 U by slow IV infusion diluted 1 in 10 in Hartmann’s solution, repeated if necessary. Individuals with severe systemic envenoming may require several vials of antivenom; use up to 5 vials has been reported. Children: 6000 Uby slow IV infusion diluted 1 in 5 in Hartmann’s solution, repeated if necessary. Action Antivenom effective against venom of death adder (Acanthophis antarcticus ). Route Onset Peak Duration IV Unknown Unknown Unknown

Reactions may be common , uncommon, life-threatening , or commonandlife-threatening.