1288 Miscellaneous drug categories
Reactions may be
common
, uncommon,
life-threatening
, or
commonandlife-threatening.
• Although considered controversial,
individuals at risk of anaphylactic reactions
may be given premedication with
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.
• Althougheffectiveagainstother
Pseudechis
genus members, tiger snake antivenom is
usually the preferred treatment.
• Monitor the person closely for at least 6
hours after administering antivenom.
Patient teaching
• Advise person of risk of possible infectious
disease transmission as venom is sourced
from horse serum.
• Instructpersontoreportanyadverseeffects
—such as shortness of breath, itching, skin
swelling, fever or chest pain—immediately.
box jellyfish antivenom
Box Jellyfish Antivenom Solution for
Injection
Pregnancy risk category NR
Use in sport: Permitted
Available form
Solution for injection:
20,000 U/vial
Indications & dosages
➤
Treatmentofboxjellyfishstingdemonstrating
systemic envenoming or extensive local
involvement—
Adults:
20,000 U by slow IV infusion diluted
1 in 10 with Hartmann’s solution, repeated
if necessary.
Children:
20,000 U by slow IV infusion
diluted 1 in 5 with Hartmann’s solution,
repeated if necessary.
Action
Antivenom against toxin of box jellyfish
(
Chironex fleckeri)
found in Australian
tropical waters.
Route Onset
Peak
Duration
IV
Unknown Unknown Unknown
Adverse reactions
Skin:
urticaria, rash.
Other:
allergic reactions,
anaphylaxis
,
delayed serum sickness
.
Interactions
None reported.
Contraindications
Should not be used unless there is evidence
of systemic envenoming or extensive local
involvement with intractable pain.
care considerations
• Box jellyfish venom contains toxins that
affect the myocardium and neuromuscular
functioning of the respiratory system and
cause dermatonecrosis. In severe cases,
death can occur in as little as 20 minutes.
• Antivenom should be administered as
soon as possible after cardiopulmonary
resuscitation has commenced.
• Not all individuals stung by box jellyfish
will require antivenom.
• As product is sourced from ovine 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.
• 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.
