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Y3R2 - Toxicology ☠️ > L13: Snake > Flashcards

L13: Snake Flashcards

1
Q

Percentage of Venomous snake bites

A
  • Only 5% to 10% of snake bites are vonomous (i.e. inject venom into the prey)
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2
Q

Families of Venomous snakes in egypt

A
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3
Q

where is snake venom present?

A
  • Saliva of snake, ejected from highly developed secretory organ (Modified parotid glands) during the act of biting.
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4
Q

Color & nature of snake venom

A
  • It is pale transparent yellow viscous secretion, when fresh.
  • Proteinous in nature, most of which are glycopolypeptides and are enzymatic in action
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4
Q

About 80-90% of viperidae consists of ….

A

enzymes

e.g. hemolysin, fibrinolysin, phospholipase in viper venom

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5
Q

25-70% of elapidae consists of ……

A

Enzymes

  • Cholinesterase, neurotoxins in elapidae venom.
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6
Q

what secretes Neurotoxic venom?

A
  • Elapidae,
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7
Q

Characters of Neurotoxic venom

A
  • It has a curare-like action
  • Causing paralysis of motor nerve endings in voluntary muscles.
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8
Q

What secretes Vasculotoxic venom?

A

Viperidae

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9
Q

Characters of Vasculotoxic venom

A
  • It contains phospholipase enzyme.
  • It produces destruction of RBCs leading to extra and intravascular hemolysis.
  • This action is manifested as coagulative disorders and Thrombocytopenia with bleeding tendency from external orifices of the body and site of the bite.
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10
Q

what secretes Myotoxic venom?

A

Hydrophidae.

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11
Q

Characters of Myotoxic venom

A

Simulates the neurotoxic

  • As it produces generalized muscular pain and weakness
  • Followed by degeneration of the muscles
  • Myoglobinuria ending in respiratory and renal failure in fatal cases.
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12
Q

CP of of snake bites

A

Local & Systemic effects

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13
Q

Local effects of Elapid snake bite (Neurotoxic venom)

A
  • Mild or minimal swelling and inflammation around fang marks.
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14
Q

Systemic effects of Elapid snake bite (Neurotoxic venom)

A
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15
Q

what is the first neurological sign of Elapid snake bite (Neurotoxic venom)?

A

Ptosis

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16
Q

what are characteritic effects for Elapidae snakes (Other than local & Systemic effects)?

A

Ophthalmic effects

17
Q

Ophthalmic effects of Elapidae

18
Q

Local effects of Viper snake bite (Vasculotoxic venom)

19
Q

Systemic effects of Viper snake bite (Vasculotoxic venom)

20
Q

Local effects of Sea snake bite (Myotoxic)

A

Mild or minimal local swelling around the fang marks.

21
Q

Systemic effects of Sea snake bite (Myotoxic)

22
Q

Dx of Snake Bite

23
Q

TTT aspects of Snake Bite

A
  • Reassurance
  • Local effects
  • Systemic effects
  • Decontamination
  • Enhanced Elimination
24
Q

Reassurance (Snake Bite)

A
  • To prevent death from neurogenic shock since most bites are non-venomous
25
Q

TTT of Local effects in Snake Bite

26
Q

TTT of Systemic effects in Snake Bite

A
  • Emergency and supportive care
  • Antidote (Antivenin)
27
Q

Antidote in cases of Snake Bite

A

(Antivenin)

28
Q

Indication of antivenin in Snake Bite

A

All snake bite with local or systemic toxicities

29
Q

Site of TTT of patients with Snake Bite

A

Treat all patients in an intensive care unit.

30
Q

Time of Dermal Sensitivity Test

A
  • Perform skin test for horse serum sensitivity only. when signs of envenomation are present and imminent antivenin therapy is anticipated

using 1:10 dilution of antivenin.

31
Q

How to prepare the patient before skin test & antivenin adminstration?

A

Insert preferably two secure IV lines.

32
Q

Anti-prophylactic measures if antivenin is used in a patient with a positive skin test

A
  • Pre-freatment with IV diphenhydramine, hydrocortisone, dexamethasone, and calcium
  • Have ready at the bedside a preloaded syringe containing epinephrine (1/10,000 for IV use) in case of anaphylaxis.
33
Q

Do you abandon antivenin if skin test is positive?

A
  • Do not abandon antivenin therapy if skin test is positive.
34
Q

Does negative skin test exlude anaphlyaxis in cases of dermal sensitivity test?

A

Even if skin test is negative, anaphylaxis may still occur unpredictably.

35
Q

Doses of antivenin

36
Q

Decontamination in Snake bite

A
  • Remain calm, wash area with soap and water and remove any constricting clothing or jewelry.
  • Do not apply ice to the site.
  • Do not apply a tourniquet and immobilize the extremity.
  • Do not make cuts over the bite site.
36
Q

End point of antivenin

A
  • It is the reversal of systemic manifestation (e.g., shock, coagulopathy and parethesias),
  • Halting of progressive oedema and pain.
37
Q

Emergency TTT Snake Bite

37
Q

Enhanced Elimination in Snake Bite

A

Dialysis, haemoperfusion, and charcoal administration are not effective.

Y3R2 - Toxicology ☠️ (15 decks)

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