Week 9 Flashcards by caitlin gill

what agents does snake venom contain?

pain producing agents
enzymes
nephrotoxins
cardiotoxins
myotoxins
neurotoxins
haemotoxins
coagulopathy agents

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what do myotoxins do?

direct effect on muscle:

pain
weakness
dark urine

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what do haemotoxins do?

destroy red blood cells
reduces ocygen transport
stops clotting

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how does snake venom neurotoxin affect nerves?

presynaptic - presynaptic neuroblockade preventing release of aCH
postsynaptic - toxins bind to aCH preventing the interaction between them and receptors on postsynaptic membrane.

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what do nephrotoxins do?

kidneys are affected as a result of hypertension, myolysis or coagulopathy

more likely to get this if you have been drinking

Early signs are low and no urine production

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what kind of snakes produce nephrotoxins?

brown
tiger
mulga
taipans
rough scaled snake

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what are cadiotoxins?

cause cardiac muscle damage or heart electrophysiology dysfunction

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what are s&s of snake bites?

headache
pain and swelling
nausea/vomiting/abdo pain
paralysis with resp loss
ptosis (droopy eyelids)
Partial opthalmoplegia (paralysis of eye muscles)
diplopia (double vision)
Dysarthia (difficulty speaking)
loss of facial expression
myolysis (dark urine)
convulsions
progressive weakness
slurred speech
neurotoxins
coagulation disturbances
coagulopathy
anticoagulant
kidney damage

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what snakes are in victoria?

eastern brown
red-bellied black
some death adder species
toger
common copper head

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how does venom move through the body?

lymphatic system

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What are the 2 types of antivenoms?

Monovalent antivenom - against one species

Polyvalent - a combination of all species

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what are some complications that can occur as a result of antivenoms?

anaphylactic shock

if given in excess it may block receptor sites

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how does spider venom work?

targets neuromuscular joints
connective tissue
nervous system
neurotoxins
enzymes

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what are the symptoms of a red back bite?

sharp pain at site
local sweating
nausea & vomiting
headache
piloerection
hypertension & tachycardia

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When are redback bites more common?

warmer months

> 250 per year

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how does the redback toxin work?

acts on pre-synaptic neuron. causing huge release and then leading to depletion of NA and ACh resulting in patchy paralysis of Neuromuscular junction

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what are the 2 phases of a funnel web spider bite?

Phase 1 - autonomic storm:
pain at bite site
piloerection
muscle spasms
tachycardia
hypertension
nausea
vomiting
abdo pain
salivation
lacrimation
death due to pulmonary oedema

Phase 2 - resolution:
resolution of phase 1 symptoms, 
refractory hypotension
cessation of breathing
cardiac arrest

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What toxins are in a funnel web spider bite?

Neurotoxins act on nerve fibres producing spontaneous repetitive action potentials leading to uncoordinated muscle twitching

slows sodium channel inactivation

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what are symptoms of mouse spider bite?

Venom similar to funnel web

muscle spasms
hypertension
opisthotonus (arched back)
unconscious

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what are the symptoms of white tail spider bite?

mild stinging and sharp pain
swelling
erythema

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How do you treat a red back spider bite?

ice packs
pressure immobilisation is NOT recommended
Red back antivenom

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how do you treat a funnel web bite?

pressure imbolisation

same as snake

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When do funnel web bites need antivenom?

oral paraesthesia
tongue fasciculation
salivation
uncontrolled twitching
tachycardia

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how do you treat white tail bite?

ice pack
simple analgesics
see doctor if pain and swelling persists

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what are the group of insects that are medically significant in australia?

hymenoptera order of insects - bees - wasps - stinging ants

hat are symptoms of bee stings?

swelling local pain erythema

what is the toxin in bee stings?

Melittin - breaks down phospholipid layer of cells and releases histamine Histamine

how do you treat a bee sting?

``` remove stinger control swelling (ice + elevate) remove jewlery that ay be restrictive treat pain antihistamines ```

what are the symptoms of wasp sting

swelling erythema local pain risk of severe allergic reaction

How do you treat a wasp sting?

- clean area with soap and warm water - remove jewlery - use cold pack to reduce swelling and pain - use pain-relieveing medications and creams - antihistamines - look for anaphylaxis

what is the distinguishing feature of paralysis ticks?

front and back legs are darker than middle legs

how does tick toxin work?

Holocytoxin | - acts pre-synaptically reducing release of ACh

What are the symptoms of tick infestation?

``` lethargy weakness unsteady gait slurred speech loss of apetitie dilated oupils ascending symmetrical aralysis ``` can result in lyme disease

what is the pre hospital treatment for ticks?

ventilation due to resp paralysis | freeze dont squeeze

What is lyme disease?

infection caused by bacteria transmitted when bitten by a tick

what are the symptoms of lyme disease

bullseye rash headache fever fatigue

What is ross river fever?

``` spread by mozzies joint pain influenze like sysmptoms fever fatigue rash ```

what is dengue fever

sudden fever headache muscle and joint pains

what are the s&s of centipede bite

mild to sever local pain - swelling and erythema - minimal system effects risk of infection

how do you treat a centipede bite

analgesia | ice for pain and swelling

what are s&s of caterpillar bites?

wheals and wide spread rashes burning sensation if in resp tract - laboured breathing risk of infection

how do you treat a catepillar sting

``` sticky tape wash injured area with soap and water ice packs monitor for allergic reactions analgesia and antihistamines ```

how do you treat a scorpion sting?

analgesia and ice packs

how does the blue ringed octopus toxin work?

Tetrodotoxin - neuromuscular blockade , rep arrest blockade of voltage gated Na+ channels

how do you treat blue ring octopus envenomation?

pressure immobilisation resuscitation closely monitor cardio vascular NO ANTIVENOM

how does cone shell toxin work?

conotoxins | - ion channel toxin that causes paralysis

how do you treat a cone shell?

pressure bandage supportive care no antivenom

what are symptoms of cone shell envenomaion?

local pain neurologic impairment progressive paralysis resp failure

what are syptoms of stone fish sting?

immediate severe pain swelling and erythema risk of shock

how do you treat stone fish?

``` wash site and clear debris immerse in hot water for 20 mins repeat as needed to 2 hours pain relief supportive care if analgesic and hot water do not reduce effects, stonefish antivenom is needed ```

what are S&S of lion fish?

``` intense throbbing sharp pain tingling sweating blistering headache nausea abdo pain seizures paralysis of limbs breathing difficulties heart failure pulmonary oedema LOC ```

how do you treat lion fish sting?

hot water antivenom (stonefish) narcotic analgesic

how do you treat a scorpion fish sting?

``` wash site immerse in hot water pain relief supportive care stonefish antivenom ```

what are s&s of a toadfish?

``` parasethsia of lips and tongue muscle weakness cyanosis hypotension coma ```

how do you treat toadfish if ingested

decontamination - activated charcoal immediate supportive care resp support

what are some s&s of sting ray barbs

``` nausea vomiting sweating cramps local pain ```

how do you treat a stingray barb?

``` bath wound in sea water and clean if safe remove barbs immerse in hot water if bleeding apply pressure pain relief ```

what are s&s of bluebottle jellyfish stings?

immediate intense pain | rash or loacalised redness

how to you treat a bluebottle sting?

wash with seawater remove tenticles wih gloved hands immerse in hot water for 20 mins (at least 45 degrees) vinegar not recommended

what are s&s of irunkandji syndrome?

``` vomiting profuse sweating headache agitation rapid heart rate increase in BP pulmonary oedema ```

how do you treat tropical jellyfish?

``` wash with vinegar remove tenticles cool packs in plastic bags (want to keep dry) pain relief monitor for cardiovasulcar complications ```

what are the venom components of sea snakes?

post synaptic neurotoxins | myotoxins

S&S of sea snakes?

eye lids drooping limb weakness myoliysis

what is the sea snake antivenom made with?

tiger snake and sea snake

how do you treat sea snake bite?

pressure bandage | monitor for paralysis