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

Antivenoms     1291

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. funnel-web spider antivenom Funnel-Web Spider Antivenom Pregnancy risk category NR Use in sport: Permitted Available form Powder for injection: 125 U/vial Indications & dosages ➤ Treatment of systemic envenoming from funnel-webspiderbite— Adults and children: 250 U by slow IV injection. Each vial should be reconstituted in 10mL water for injections BP; repeat after 15 minutes if required. IV administration • To prepare IV injection, dilute calculated dose in water for injections. • Swirl gently to fully dissolve powder. • A clear to slightly opalescent colourless solution should be achieved in 10 minutes. • Solution should be used immediately. • Administer by slow IV injection. Action Antivenom. Purified immunoglobulin sourcedfromrabbitplasma,effectiveagainst venomof funnel-web spider (Atraxrobustus). Route Onset Peak Duration IV Unknown Unknown Unknown Adverse reactions Skin: urticaria, rash. Musculoskeletal: chest pain, myalgia. Other: allergic reactions, anaphylaxis , delayed serum sickness .

Interactions None reported. Contraindications

Should not be used unless there is evidence of systemic envenoming with potential for serious toxic effects. care considerations • As product is sourced from rabbit 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 rabbit 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, 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 rabbit serum. • Instruct person to report any adverse effects—such as shortness of breath, itching, skin swelling, fever or chest pain— immediately.

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