Crotalidae polyvalent immune Fab (Crofab): Difference between revisions
m (Jonas moved page Crofab to Crotalidae polyvalent immune Fab (Crofab)) |
No edit summary |
||
| Line 10: | Line 10: | ||
The Fc portion of the antibody is eliminated after mixture with papain and subsequent purification. | The Fc portion of the antibody is eliminated after mixture with papain and subsequent purification. | ||
==Indications for Administration== | |||
{{Crofab indications}} | |||
==Dosing and Administration== | |||
*Administer antivenom as soon as possible if the indications are met and antivenom is available.<ref>Dart RC et al. Efficacy of post envenomation administration of antivenin. Toxicon. 1988;26:1218–1221.</ref> | |||
*Administration should slow swelling and decrease pain | |||
==See Also== | |||
*[[Snake bites]] | |||
*[[Crotaline (Pit Vipers)]] | |||
*[[Elapidae (Coral Snakes)]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 16:44, 1 January 2016
Background
The original Antivenin Crotalidae Polyvalent (ACP)[1] was manufactured by Wyeth Pharmaceutical for use in the US but due to severe delayed allergic reactions was discontinued. The FDA in 200 approved Crofab, an antivenom derived from sheep serum[2] The antibodies bind and neutralize venom components.
Synthesis and Production
Crotalidae polyvalent immune Fab (Crofab) is produced from sheep serum after inoculation with venom from:
- Eastern diamondback rattlesnake (Crotalus adamants)
- Western diamondback rattlesnake (Crotalus atria)
- Mojave rattlesnake (Crotalus scutulatus).
- Cottonmouth (Agkistrodon piscivorus)
The Fc portion of the antibody is eliminated after mixture with papain and subsequent purification.
Indications for Administration
The following criteria for administration after Crotalidae bite allows for clinician judgment and shared decision making with the patient due to the extreme cost of Crofab[3]
- Progression of swelling
- Abnormal results on lab tests (plt < 100,000 or fibrinogen < 100)
- Systemic manifestations (unstable vitals or AMS)
- Neuromuscular toxicity
No studies show reduction in mortality from antivenom administration.
Dosing and Administration
- Administer antivenom as soon as possible if the indications are met and antivenom is available.[4]
- Administration should slow swelling and decrease pain
See Also
References
- ↑ Howland MA, Smilkstein MJ. Primer on immunology with applications to toxicology. Contemp Manage Crit Care. 1991;1:109–145.
- ↑ Ruha AM et al: Initial postmarketing experience with crotalidae polyvalent immune Fab for treatment of rattlesnake envenomation. Ann Emerg Med. 2002;39:609–615.
- ↑ Lavonas EJ et al: Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop. BMC Emerg Med. 2011; 11.
- ↑ Dart RC et al. Efficacy of post envenomation administration of antivenin. Toxicon. 1988;26:1218–1221.