Box jellyfish antivenom

Question 1

Drug class

Answer 1

Antivenom

Question 2

Pharmacology

Answer 2

Contains concentrated immunoglobulin that acts to neutralise the toxins present in the venom.

Question 3

Metabolism

Answer 3

Heaptic & in muscle tissue

Question 4

Indications

Answer 4

Envenomation with any of the following:
• in cardiac arrest
• decreased level of consciousness
• cardiac AND/OR respiratory distress or collapse
• total surface area affected greater than surface area of one limb
• intractable pain unrelieved by ice packs, methoxyflurane AND/OR narcotic analgesia

Question 5

Contraindications

Answer 5

Allergy and/or adverse drug reaction

Question 6

Precautions

Answer 6

The antivenom is a foreign protein, which can cause sensitisation, allergic reaction or anaphylaxis

Question 7

Side effects

Answer 7

• Allergic reaction including anaphylaxis & delayed serum sickness
• Intense stinging sensation on injection

Question 8

Presentation

Answer 8

20,000 units/1.5-4ml

Question 9

Routes of admin

Answer 9

IM / IV

Question 10

Adult/Paediatric dosages

Answer 10

Envenomation assoc. with all indications EXCEPT cardiac arrest
• IM 60,000 units, single dose only
• IV INF 20,000 units over 20min, single dose
- Mix 20,000 units with sodium chloride 0.9% in 30ml Springfusor to = 20,000u/20ml

Envenomation assoc. with cardiac arrest
• IV 20,000 units, slow push over 2-5mins
Repeated IMMEDIATELY up to 2 times
TMD 60,000 units
- mix 20,000 units with 0.9% to = 20,000/20ml