Antivenoms 1289
• Vinegar should be applied liberally to
tentacles stuck to the skin in order to
prevent greater spread of venom from
nematocysts.
Patient teaching
• Advise person of risk of possible infectious
disease transmission as venom sourced
from sheep serum.
• Instruct person to report any adverse
effects—such as shortness of breath,
itching, skin swelling, fever or chest pain—
immediately.
brown snake antivenom
Brown Snake Antivenom Infusion
Pregnancy risk category NR
Use in sport: Permitted
Available form
Solution for infusion:
1000 U/vial
Indications & dosages
➤
Treatment of
Pseudonaja
genus snake
envenoming—
Adults:
1000 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. Most individuals require 3 vials
and the use of 13 vials has been recorded.
Children:
1000 Uby slow IV infusion diluted
1 in 5 in Hartmann’s solution, repeated if
necessary.
Action
Antivenomeffectiveagainstvenomofbrown
snake and othermembers of the
Pseudonaj
a
genus such as Eastern brown snake, dugite
and gwardar (Western brown snake).
Route Onset
Peak
Duration
IV
Unknown Unknown Unknown
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
• Brown snake venomcauses rapid coagulo
pathythatmaybeassociatedwithrespiratory
paralysis and thrombocytopenia.
• Monitor FBC, platelets, INR and aPTT on
presentation, immobilisation (if used) and
6 hours thereafter.
• Monitor for signs and symptoms of
bleeding (bruising, bleeding fromgums and
venepuncturesites,epistaxis,gastrointestinal
bleeding, haematuria, altered mental status
suggesting intracranial haemorrhage).
• In individuals with severe consumptive
coagulopathy, fresh frozen plasma and/or
cryoprecipitate should be considered early.
• 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,
individuals at risk of anaphylactic reactions
maybegivenpremedicationwithadrenaline
and antihistamine.
• Have adrenaline 1:1000 available in case
of anaphylactic reaction.
• Severe cases should be managed in
intensive care unit.
