Venom Flashcards
Risk factors for severe reactions to stings
- very severe previous reaction
- insect species
- age >45 years
- male sex
- multiple sequential stings
- Meds (ACE)
What is the risk of a systemic reaction in pts that had a large local to venom sting?
4-10%
How many people die a year from stings?
40 estimated in US
0.4-0.8% risk of children and 3% of adults
Mgmt for venom allergy
- Be educated on avoidance of stings
- Carry Epi and understand indications and administration
- Undergo testing sIgE
- Consider VIT
- Carry medical ID for Venom allergy
Reasons for a negative venom SPT
- Refractory period - Testing too soon after rxn
2. alternative diagnosis: mastocytosis, or other MCAS
Venom SPT doses
- SPT with 100 mcg/ml
- ID with 0.01 mcg/ml, 0.1 mcg/ml, then 1 mcg/ml
some papers say skip SPT and do 1 mcg/ml ID testing
VIT schedule
Vial 1 (1 mcg/ml) - 0.10 ml - 0.50 ml - 1.0 ml Vial 2 (10 mcg/ml) - 0.1 ml - 0.50 ml - 1.0 ml Vial 3 (100 mcg/ml) - 0.15 ml - 0.15 ml - 0.30 ml - 0.30 ml - 0.50 ml - 0.50 ml
what is the dose of venom per sting
vespids (hornets/wasps/YJ) have 2-20ug of venom per sting
100 mcg dose of YJ is roughly 5-50 stings (2 stings for Honey bee)
Risk factors for severe reactions to stings
- very severe previous reaction
- insect species
- age > 45 years
- medications like acei
antigen used to standardize honey bee and yj
HB- phospholipase A2
YJ - hyaluronidase ves v2
components in honey bee venom
api m1 - phospolipase a2
api m2- hyaluronidase
api m3 - melittin
components in vespid
dol m1
dol m2 - hyaluronidase
dol m3
dol m5 - antigen 5
components in fire ants
sol 1
sol 2
sol 3
sol 4
which insects are part of vespidae class
- YJ
- WFH
- paper wasp
which insects are part of the apidae class
- honey bee
