Comparative trial of different dose schdules of monospecific antivenom for Russell's viper
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1989-06-01
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An open comparative trial of two different dose schedules of Myanma Pharmaceutical Industry (MPI) monospecific Russell's viper venom (ASV) was carried out in 45 confirmed cases of Russell's viper envenoming. Patients included in the study were randomised by drawing lots and divided into two groups. Group one received an initial bolus dose of 40 ml of ASV (intravenous over 10 minutes) and if blood remains incoaguable 6 hours after the initial dose another dose of 40 ml was given. Group two received a bolus dose of 80 ml (intravenous over 20 minutes). Response to treatment was assessed clinically and serial measurements of blood venom antigen, coagulation factors and biochemical variables. 40 ml was found to be adequate in 48
of envenomed patients without systemic bleeding or heavy proteinuria. For patients with these features 40 ml is usually not adequate to correct the coagulation defect. In these patients the venom antigen was cleared significantly more rapidly if 80 ml was given as a single bolus dose. Therefore a single bolus dose of 80 ml is recommended in these patients. But development of acute renal failure was not prevented by increasing the dose to 80 ml.
of envenomed patients without systemic bleeding or heavy proteinuria. For patients with these features 40 ml is usually not adequate to correct the coagulation defect. In these patients the venom antigen was cleared significantly more rapidly if 80 ml was given as a single bolus dose. Therefore a single bolus dose of 80 ml is recommended in these patients. But development of acute renal failure was not prevented by increasing the dose to 80 ml.
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Myint Lwin, Tin Nu Swe, Myint Aye Mu, Than Than, Tun Pe. Comparative trial of different dose schdules of monospecific antivenom for Russell's viper. Myanmar Medical Journal. 1989; 34(2): 3-8