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Indian Journal of Emergency Medicine

Volume  6, Issue 1, January-March 2020, Pages 19-22
 

Original Article

Adverse Reaction Profile Following Ant-snake Venom Administration in Snakebite in a Tertiary Care Hospital: A Retrospective Cross-sectional Study

Girish Narayan1, Sharath Krishnaswami2, Shakuntala Kandikuppa Murty4

1Associate Professor, 3Professor & HOD, Department of Emergency Medicine, St. John's Medical College, Koramangala, Bengaluru, Karnataka 560034, India. 2Senior resident, Department of Anaesthesiology, Sakra World Hospital, Marathahalli, Bengaluru, Karnataka 560103, India.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.6120.3

Abstract

Introduction: Anti-snake venom therapy for snakebite envenomation is as associated with adverse drug reactions. The spectrum of reactions that are seen are wide and inconsistent. Given the annual incidence of snakebites at 2.7 million, and the frequent administration of anti-snake venom, an awareness of types of these reactions is required. Aims: To describe the adverse reactions seen during anti-snake venom therapy and treatment options used. Settings and design: Retrospective cross-sectional design in a Tertiary care Hospital. Methods: For a period of two years from January 1st, 2010 to December 31st, 2011 all cases diagnosed to have ani-snake venom reactions were identified retrospectively. Following identification, case record review was undertaken to collect data regarding the demographics, envenomation, characteristics of the reaction and treatment employed. Statistical analysis used: Descriptive statistics for demographic features of age and sex were obtained. Age was analyzed as a continuous variable and further categorization was done. Proportions of type of envenomation, ADRs and post-reaction medication were also calculated. Results: Forty-one cases were identified to be included in the study population. The mean age was 33 ± 13.3 years. Urticaria, chills, dyspnea/bronchospasm, tachycardia, bradycardia and hypotension were seen in 48.8%, 19.5%, 17.1%, 39%, 19.5% and 51.2% of the population respectively. 34.2% of reactions were treated with a combination of pheniramine, hydrocortisone and epinephrine. Conclusions: The results suggest that there is wide range of possible adverse reactions when anti-snake venom is given. Hypotension is a frequent lifethreatening event and should be watched for. Though therapy is similar in other studies there are no clear guidelines for the same. Premedication needs to be evaluated further. 

Keywords: Adverse drug reactions; Anti-snake venom; Snakebite; envenomation.


Corresponding Author : Girish Narayan