title: Antivenoms for snakebite: design, function, and controversies.
abstract: BACKGROUND
  Animal-derived antivenoms have been used to treat snake envenomation for more than 100 years. Major technological advantages in the past 30 years have produced antivenoms that are highly purified and chemically modified to reduce the risk of acute hypersensitivity reactions. Like all pharmaceutical manufacture, commercial-scale antivenom production requires making trade-offs between cost, purity, pharmacokinetic profile, and production yield.
  
  
  METHODS
  This article reviews the current state of the art for antivenom production and development. Particular attention is paid to controversies and trade-offs used to achieve a balance between improved safety and pharmacokinetic performance.
authors.affiliation: Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado, USA. eric.lavonas@rmpdc.org
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lavonas
mesh_terms: D000818:Animals; D000997:Antivenins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015195:Drug Design; D006207:Half-Life; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D012909:Snake Bites / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000997:Antivenins; C431183:Crotalidae Polyvalent immune Fab; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments