Ophitoxemia (Snakebite)
Ophitoxemia is generally poisoning by snake venom, from the Greek words “ophis” for snake and “toxon” for poison. It is a pathologic condition caused by the poisonous venom injected into the tissues by the fangs in certain snakes, which are followed by various toxic symptoms and signs.
• Snake venom: Venom is the saliva of a snake, ejected from the poison apparatus modified parotid gland during the act of biting. It can be neurotoxic, vasculotoxic, or myotoxic in its action.
• Appearance: Slight transparent yellow and viscous when fresh.
• Toxic principles: Proteinous in nature, most of which are glycopolypeptides and are enzymatic in action. About 80-90% of viperidae and 25-70% of elapidae venom consists of enzymes.
For more information read FMT (Forensic Medicine and Toxicology) or in Ayurveda, Agad Tantra.
• Fibrinolysins | • Neurotoxins (elapid venom) |
• Proteolysins | • Cholinesterase |
• Hemolysins (viper venom) | • Thromboplastin(viper venom) |
• Agglutinins. | • Cardiotoxins |
• Coagulase | • Hyaluronidase |
• Phospholipase. | • Lecithinase |
Fatal dose
Snake Fatal dose (dried form) • Cobra 15 mg
• King cobra 12 mg
• Common krait. 2.5-6 mg
• Banded krait 10 mg
• Russell’s Viper 40 mg
• Saw-scaled Viper 8 mg
➔ Fatal period: Death may occur immediately from shock due to fright.
• Cobra: 1⁄2-24 h.
• Viper: 1-4 days.
Effects of Ophitoxemia:
1. Local effects: Pain, swelling, bruising, and tissue necrosis at the site of the bite.
2. Systemic effects:
❖ Hemotoxic effects: Bleeding disorders, low blood pressure, and damage to blood
vessels.ex- Russell’s viper.( Maximum pain= viper),viperidae venom.
❖ Neurotoxic effects: Muscle paralysis, respiratory failure, and other nervous system disruptions.ex- cobra.(Naja Naja),elapidae venom.
❖ Myotoxic effects: Muscle damage and renal failure due to myoglobin À.ex- sea snake.
3. Allergic reactions: In some instances, the venom from snakes may cause anaphylaxis or other immune system-related disorders.
Test:
● Whole blood clotting test, 20 min W.B.C T.
● If the blood is coagulated the patient is bitten by vipride species ( viper)
● If the blood is still uncogulated, the patient is bitten by Elapide species cobra.
Treatment:
➢ ASV – Anti Snake venom is advised in the moderate and severe category.
➢ First aid: Immobilize the limb, avoid suctioning venom, and seek immediate medical care.
➢ Antivenom is considered the main treatment for ophitoxemia, which is specific for the type of snake.
➢ Supportive care: Pain management, wound care, and treatment of complications like infection or organ failure.