Antivenoms 1293
Indications & dosages
➤
Treatment of systemic envenoming fromsea
snakebite—
Adults:
1000 U by slow IV infusion diluted
1 in 10 in Hartmann’s solution or normal
saline, repeated if necessary. In severe
envenoming, doses up to 10,000 units may
be used.
Children:
1000 Uby slow IV infusion diluted
1 in 5 in Hartmann’s solution or normal
saline, repeated if necessary.
Action
Antivenom effective against venom
Enhydrina schistosa
and, to varying effect,
other sea snakes present in northern
Australian waters.
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
• Sea snake venom contains potent neuro
toxins that cause muscle paralysis and
respiratory failure, as well as myolytic prop
erties causing myalgia, muscle weakness,
trismus, ptosis, ophthalmoplegia, hyper
kalaemia and renal failure in severe cases.
• Myolysis causes elevation of serum
glutamic oxaloacetic transaminase (SGOT),
which can be used to determine or monitor
the degree of envenoming.
• Monitor renal function, urine output,
serum electrolytes and urinalysis.
• 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, manifestedby albuminaemia,
arthralgia, fever, lymphadenopathy and skin
eruptions.
• 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.
• Instruct person to report any adverse
effects—such as shortness of breath,
itching, skin swelling, fever or chest pain—
immediately.
stonefish antivenom
Stonefish Antivenom Solution for
Injection
Pregnancy risk category NR
Use in sport: Permitted
Available form
Solution for injection:
2000 U/vial
