Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Iliev, Yanko T.; Tufkova, Stoilka; Zagorov, Marin Y.; Nikolova, Stanka M.

doi:10.2478/folmed-2014-0005

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…Apart from Zagreb antivenom, there is clinical evidence, although very limited, for some other European antivenoms which demonstrate effectiveness after i.m. administration [ 151 , 152 ]. The duration of the hospital stay, as another reasonable marker of antivenom effectiveness, was shorter for patients pre-treated with i.m.…”

Section: Clinical Studiesmentioning

confidence: 99%

Snake Antivenoms—Toward Better Understanding of the Administration Route

Gamulin,

Mateljak Lukačević,

Halassy

et al. 2023

Toxins

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Envenomations induced by animal bites and stings constitute a significant public health burden. Even though a standardized protocol does not exist, parenterally administered polyclonal antivenoms remain the mainstay in snakebite therapy. There is a prevailing opinion that their application by the i.m. route has poor efficacy and that i.v. administration should preferentially be chosen in order to achieve better accomplishment of the antivenom therapeutic activity. Recently, it has been demonstrated that neutralization not only in the systemic circulation but also in the lymphatic system might be of great importance for the clinical outcome since it represents another relevant body compartment through which the absorption of the venom components occurs. In this review, the present-day and summarized knowledge of the laboratory and clinical findings on the i.v. and i.m. routes of antivenom administration is provided, with a special emphasis on the contribution of the lymphatic system to the process of venom elimination. Until now, antivenom-mediated neutralization has not yet been discussed in the context of the synergistic action of both blood and lymph. A current viewpoint might help to improve the comprehension of the venom/antivenom pharmacokinetics and the optimal approach for drug application. There is a great need for additional dependable, practical, well-designed studies, as well as more practice-related experience reports. As a result, opportunities for resolving long-standing disputes over choosing one therapeutic principle over another might be created, improving the safety and effectiveness of snakebite management.

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Section: Clinical Studiesmentioning

confidence: 99%

Snake Antivenoms—Toward Better Understanding of the Administration Route

Gamulin,

Mateljak Lukačević,

Halassy

et al. 2023

Toxins

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“…The mortality rate even with modern treatment may be as high as 40%. 3 Management of phalloides syndrome centers around decontamination, reduction of toxic load, and trying to prevent initial uptake and hepatic injury. 3 Meticulous supportive care is also indicated.…”

Section: To the Editormentioning

confidence: 99%

“…3 Management of phalloides syndrome centers around decontamination, reduction of toxic load, and trying to prevent initial uptake and hepatic injury. 3 Meticulous supportive care is also indicated. There is no high-quality evidence base for any particular treatment.…”

Section: To the Editormentioning

confidence: 99%

“…Early administration of silibinin, 2,3 N -acetylcysteine, 2 and high-dose benzylpenicillin 2,5 have been associated with increased survival in death cap poisoning. Penicillin displaces amatoxin from albumin, and decreases its uptake by hepatocytes.…”

mentioning

confidence: 99%

“…5 Silibinin, an extract from the blessed milk thistle ( Silybum marianum ), inhibits amatoxin penetration of liver cell walls by competing with amatoxin for bile salt transport systems. 3 It is administered in 4 equal doses and is calculated at 20 mg · kg –1 · day –1 , although this is a consensus rather than evidence-based dose. 2 Both benzylpenicillin and silibinin should be given to patients with confirmed or suspected poisoning as soon as possible, preferably in the gastrointestinal phase of the illness.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Accidental Poisoning by Death Cap Mushrooms: Be Careful What You Eat

Lawton

Bhraonáin

2013

Wilderness & Environmental Medicine

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Antivenom for European Vipera species envenoming

Lamb

Haro

Lonati

et al. 2017

Clinical Toxicology

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There are very limited pre-clinical comparative data and no randomised controlled trials assessing effectiveness of the antivenoms against different Vipera species. Most descriptive data suggest the efficacy of Zagreb, ViperFAV and ViperaTAb antivenoms by the intravenous route but not intramuscular route, although this is level D evidence. Reported adverse reactions were rare, suggesting that the modern intravenous antivenoms are of good quality. Better and more systematic data, including perhaps randomized controlled trials comparing different antivenoms, are required for the many hundreds of antivenom administrations that occur annually across Europe.

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Snake Venom Poisoning in the Plovdiv Region from 2004 to 2012

Abstract: The algorithm of Clinical Pathway 293 (CP) is effective and conducive to the reduction of duration of the morbid condition. There are, however, still aspects of it that can be optimised.

Cited by 4 publications

References 6 publications

Snake Antivenoms—Toward Better Understanding of the Administration Route

Snake Antivenoms—Toward Better Understanding of the Administration Route

Accidental Poisoning by Death Cap Mushrooms: Be Careful What You Eat

Antivenom for European Vipera species envenoming

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