Chemistry: A polyvalent pit viper IgG antivenin prepared in horses hyperimmunized to venoms of the eastern and western diamondback rattlesnakes (Crotalus spp.) and the tropical fer-de-lance (Bothrops spp.). Mechanism: Direct Ag/Ab antagonism. Contraindications: Horse serum allergy, prior antivenin allergy; relative contraindication is a positive skin test. Soon to be replaced by less antigenic polyvalent Crotalid Fab (CroFab®).
Use: All proven eastern and western coral snake bites.
Dose: 3-5 vials, up to 10 vials. Side effects: Since less antivenin is used for small coral snake envenomations, there are fewer hypersensitivity reactions; nevertheless, serum sickness remains a high possibility.
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