title: Dosage comparison of snake anti-venomon coagulopathy.
abstract: This study was done to determine whether high or low dose ofanti-snake venom (ASV) is better incoagulopathy invictims of envenoming by vipers. This retrospective study was conducted on the 154 patients (Mean age ± SD, Range) of viper snake bites who were referred to the emergency ward of Razi Hospital, Ahvaz, Iran over 2 years period (2004-2006).According to the treatment dosage the patients were divided in two groups include group 1(78 cases), low dose regimen and group 2 (76 cases), high dose one. In group 1, the treatment was performed by administration of 4 to 6 vials of ASV through intravenous infusion.In group 2, the patients were given 5 to 10 vials of ASV as an initial dose. In low dose regimen, the number of received packed red blood cell was higher (14 vs. 3) in comparison with high dose group. The number of ASV vials the patients received was 5.5and 21.06 in group 1 and 2, respectively (5.5±1.7 vs. 21.06±10.89; p < 0.01).The difference in frequency of coagulopathy complications, and need for using packed red blood cell were statistically significant(96.2% and 17.9% in group 1 vs. 34.2% and 3.9% in group 2, p < 0.01).It seems that cautious usage of high dose of ASV (10-20 vials) without very special concerns about the cost, dose, and without hazardous side effects is essential for the routine management of sever snake envenoming.
authors.affiliation: Department of Clinical Toxicology, Razi Hospital, Jundishapur University of Medical Sciences,Ahvaz, Iran.
authors.forename: Ali Hassan
authors.initials: AH
authors.lastname: Rahmani
authors.affiliation: Department of Pharmacology and Toxicology, School of Pharmacy, Jundishapur University of Medical Sciences, Ahvaz, Iran. ; Toxicology Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Jalali
authors.affiliation: Department of Clinical Toxicology, Razi Hospital, Jundishapur University of Medical Sciences,Ahvaz, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Alemzadeh-Ansari
authors.affiliation: Department of Clinical Toxicology, Razi Hospital, Jundishapur University of Medical Sciences,Ahvaz, Iran.
authors.forename: Mina
authors.initials: M
authors.lastname: Tafazoli
authors.affiliation: Toxicology Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Fakher
authors.initials: F
authors.lastname: Rahim
keywords: Anti-snake venom; Coagulopathy complication; Iranian snakes; Snake bite
references.citation: Med J Aust. 2008 Apr 21;188(8):473-6
references.pmid: 18429716
references.citation: J Assoc Physicians India. 2004 Jan;52:14-7
references.pmid: 15633711
references.citation: Med J Aust. 1999 Jan 18;170(2):92; author reply 92-3
references.pmid: 10026691
references.citation: PLoS Negl Trop Dis. 2009 Dec 22;3(12):e569
references.pmid: 20027216
references.citation: Cad Saude Publica. 2003 Jan-Feb;19(1):7-16
references.pmid: 12700779
references.citation: Southeast Asian J Trop Med Public Health. 1999;30 Suppl 1:1-85
references.pmid: 10983553
references.citation: N Engl J Med. 2002 Aug 1;347(5):347-56
references.pmid: 12151473
references.citation: J Trauma. 1983 Nov;23(11):1012-4
references.pmid: 6632024
references.citation: Anaesth Intensive Care. 1996 Jun;24(3):379-81
references.pmid: 8805896
references.citation: Anaesth Intensive Care. 1991 Nov;19(4):530-4
references.pmid: 1750633
references.citation: J Ayub Med Coll Abbottabad. 2008 Jul-Sep;20(3):125-7
references.pmid: 19610536
references.citation: J Infect Public Health. 2008;1(1):51-5
references.pmid: 20701846
references.citation: Am J Trop Med Hyg. 2009 Oct;81(4):725-31
references.pmid: 19815895
references.citation: Med J Aust. 2004 Dec 6-20;181(11-12):703-5
references.pmid: 15588174
references.citation: Emerg Med J. 2005 Jun;22(6):397-9
references.pmid: 15911942
references.citation: Am J Trop Med Hyg. 1997 Nov;57(5):605-9
references.pmid: 9392603
references.citation: J Trauma. 1988 Jul;28(7):1032-7
references.pmid: 2899649
references.citation: Trop Doct. 1998 Oct;28(4):223-6
references.pmid: 9803844
references.citation: QJM. 2009 Aug;102(8):563-8
references.pmid: 19570990
references.citation: Med J Aust. 1991 Dec 2-16;155(11-12):761-4
references.pmid: 1745167
references.citation: Med J Aust. 1998 Sep 7;169(5):257-8
references.pmid: 9762063
references.citation: Iran J Pharm Res. 2012 Fall;11(4):1183-9
references.pmid: 24250552
references.citation: Pathology. 2002 Apr;34(2):157-61
references.pmid: 12009098
references.citation: Emerg Med (Fremantle). 2003 Oct-Dec;15(5-6):500-10
references.pmid: 14992068
references.citation: Eur J Intern Med. 2006 Jan;17(1):24-7
references.pmid: 16378881
references.citation: South Med J. 2000 Jun;93(6):562-6
references.pmid: 10881769
references.citation: Crit Care Resusc. 2002 Jun;4(2):84-6
references.pmid: 16573409
references.citation: J Infect Public Health. 2009;2(4):167-70
references.pmid: 20701878
references.citation: QJM. 1997 May;90(5):323-34
references.pmid: 9205667
references.citation: Acad Emerg Med. 2001 Feb;8(2):177-82
references.pmid: 11157295
references.citation: J Assoc Physicians India. 1999 Apr;47(4):369-71
references.pmid: 10778516
references.citation: Toxicon. 2010 Dec 15;56(7):1223-35
references.pmid: 19951718
references.citation: PLoS Med. 2008 Nov 4;5(11):e218
references.pmid: 18986210
references.citation: J Assoc Physicians India. 2006 Sep;54:717-9
references.pmid: 17212020
references.citation: QJM. 2004 Nov;97(11):717-27
references.pmid: 15496528
references.citation: Med J Aust. 1999 Jan 18;170(2):92; author reply 92-3
references.pmid: 10026692
references.citation: Am J Trop Med Hyg. 1997 Mar;56(3):291-300
references.pmid: 9129531