Snake Bites

1
Snake Bites
2
Introduction

• There are over 3,000 species of snakes on the
  Planet, but only 15 are considered to be
  dangerous
• Snakes are found on every continent except
  Antarctica
• Every State except Alaska, Hawaii, and Maine are
  home to at least 20 venomous snake species
• Each year there are 45,000 incidents of snake
  bites in the U.S.
• 7,000 - 8,000 are from venomous snakes
• On average 10 people die each year
• The literary word for snake is serpant which
  comes from Old French meaning to creep.
• The snake is also used as the symbol for medicine
  because of its relation to Asclepius, the Greek
  god of Medicine.

3
Snake Venom

• Snake Venom is a Toxin (Hemotoxin Neurotoxin, or
  Cytotoxin)
• A varied form of saliva
• It is excreted through a modified parotid
  salivary gland
• Located on each side of the skull
• Behind the eye
• Snake venoms are a combination of proteins and
  enzymes
• The flow of venom is produced through a pumping
  mechanism from an alveolar sac that stores the
  venom, proceeds through a channel, down a tubular
  fang which is hollow in the center to project the
  venom into the air or its prey
• Though the venom is dangerous, since it is not
  inhaled it cannot be considered a Poison

4
Benefits

• Although snakes have been deemed as one of the
  worlds most dangerous and disgusting critters on
  the planet, they actually have some benefits
• Help control the smaller members of the animal
  kingdom from becoming overpopulated
• They save farmers a minimum of seventy-five
  dollars annually by ridding their fields of
  destructive rodents
• Snakes eat harmful rodents (mice, rats, etc.) and
  insects that may carry harmful diseases
• Snakes also possess an oil that can be harvested
  that is used to remedy pain in joints, such as
  rheumatoid arthritis. The fats and the oils
  extracted from the snakes have a high content of
  Eicosapentaenoic acid (EPA), hence it is thought
  to have inflammation reduction properties.

5
Snake Video

• Snake Bite Video

6
Venom

• Varies widely between species and even within a
  species
• Geographic location
• ex. Mojave rattlesnake
• Age of snake
• Last feeding
• http//www.reptileallsorts.com/bites-venom.htm

7
Venom

• 90 protein by dry weight and most of these are
  enzymes
• 25 different enzymes have been isolated from
  venoms and 10 of these occur frequently in most
  venoms
• Synergistic effects different venoms contain
  different combinations of enzymes causing a more
  potent effect than any of the individual effects
  (very similar to drug synergism)
• Generally speaking, venoms are either neurotoxic,
  hemotoxic or cytotoxic and the enzymes in the
  venom are responsible for these effects

8
Mechanism of Toxicity

• The most common
• types of enzymes are
• proteolytic, phospholipases,
• and hyaluronidases
• Proteolytic Enzymes digestive properties
• Phospholipases degrade lipids
• Hyaluronidases speed venom spread through the
  body
• http//jrscience.wcp.muohio.edu/fieldcourses03/Pap
  ersCostaRicaArticles/VenomousSnakeGoodness.AnA.htm
  l
• http//www.reptileallsorts.com/bites-venom.htm

9
Mechanism of Toxicity

• Collagenases
• Phosphodiesterases
• Acetylcholinesterase
• Circulatory System
• Effects
• http//jrscience.wcp.muohio.edu/fieldcourses03/Pap
  ersCostaRicaArticles/VenomousSnakeGoodness.AnA.htm
  l

10
Mechanism of Action

• Toxic effects are the most common focus of snake
  venom but often the compounds responsible for
  these effects can be isolated and used for
  beneficial purposes
• Can range from anti-venom production, to multiple
  sclerosis treatment, and slowing of cancer growth
  and metastasis rates

11
Mechanism of Action

• A study done in 2006
• isolated denmotoxin from
• mangrove catsnake venom
• Strong neurotoxic effects on
• birds with little on mice
• Able to research and isolate compounds to make
  discoveries in anit-coagulant, antiplatelet, and
  anti-hypertensive agents as well as
  anti-angiogenic compounds for cancer treatment
• http//www.news.vcu.edu/vcu_view/pages.aspx?nid17
  32

12
Mechanism of Action

• Another group of researchers isolated an enzyme,
  called fibrolase, in rattlesnake venom
• Showing great promise in dissolving blood clots,
  like those associated with heart attacks,
  strokes, and deep-vein thrombosis
• Clot-busting drugs on the market now dissolve the
  blockages in two steps while the fibrolase
  directly attacks the clots
• http//www.usc.edu/hsc/info/pr/hmm/01summer/slimy.
  html
• http//www.fotosearch.com/photos-images/rattlesnak
  e.html

13
Mechanism of Action

• Cancer Treatment
• One study isolated a component in cobra venom
  that inhibits DNA and RNA synthesis
• Used in the treatment of breast cancer
• Another study looked at a component of venom
  called contortostatin
• Inhibits cancer cells from moving through blood
  vessel walls, leading to fewer metastases
• http//www.pps.org.pk/PJP/3-1/0720DMShaikh.pdf
• http//www.usc.edu/hsc/info/pr/hmm/01summer/slimy.
  html

14
Body Clearance

• The way in which the body clears or neutralizes
  venom is still not fully understood
• A recent study was done looking at the effects
  of antivenin (Fab/Fab2) on the process of
  absorption and elimination in rabbits
• They found the venom rapidly disappeared from the
  injection site, but was slow to reach the
  vascular system, suggesting that its partially
  absorbed in lymphatic circulation
• Fab2 with antivenin elimination is slower than
  that of free venom with antivenin
• It suggests Fab2 is eliminated by phagocytosis
• http//jpet.aspetjournals.org/cgi/content/full/285
  /2/490

15
Side Effects

• Respitory paralysis
• Fever
• Rapid Pulse
• Increased Thirst
• Dizziness
• Local Tissue Damage
• Blurred vision
• Nausea and vomiting
• Diarrhea
• Coma
• Death
• http//www.drugs.com/enc/snake-bite.html

16
Case Study 1

• 41 year old male
• Bitten on left third finger by Gaboon Viper
• Necrosis and Blanching noticed upon arrival to ER
• Numbness and edema were also present to hand
• Prothrombin time was 15.53 (normal range
  11.0-13.0)
• International normal ratio 1.2
• There was moderate leucocytosis and normal
  platelets
• The patient was treated with intravenous
  antibiotics, diphenhydramine, hydrocortisone, and
  five 10ml vials of South African Institute of
  Medical Research (SAIMR) antivenin.
• Over next eight hours the patient developed
  lymphangitis of the left arm.
• The patients lymphangitis later resolved but he
  later required amputation of his left third
  finger.
• . Department of Emergency Medicine, University of
  Pennsylvania, Philadelphia, Pennsylvannia,
  USA
• http//reptilis.net/serpentes/venom.html

17
Case Study 2

• 24 year old male zoo employee
• Bitten on hand while changing Gaboon Vipers
  water
• Noticed local Pain and nausea upon arrival to
  emergency room
• Finger was oozing blood from the site of the bite
• He was unable to move digits 1 through 4.
• Dorsal Compartment pressure of the hand was
  greater than 40mm Hg
• Prothrombin time was 26.7 sec
• INR was 2.67
• The patient was treated with intravenous
  antibiotics, diphenhydramine, hydrocortisone, and
  twelve 10ml vials of South African Institute of
  Medical Research (SAIMR) antivenin.
• He also required local debridement and dorsal
  fasciotomy
• Post-operatively his right hand compartment
  pressure and neurovascular status normalized.
• He underwent two subsequent debridements and was
  discharged with outpatient physical therapy
• http//reptilis.net/serpentes/venom.html

18
Summary

• If people are going to keeps venomous snakes as
  pets a safety plan should always be put in effect
  to minimize effects upon envenomation.
• There are many benefits of snake venom including
• Blood clot thinner
• Cancer Treatment
• Eradicating pest
• Remedy Joint pain such as Arthritis
• Venom is 90 protein, there are 3 types of
  venomous snakes
• Neurotoxic
• Hemotoxic
• Cytotoxic
• http//en.wikipedia.org/wiki/Snakes
• http//library.thinkquest.org/CR0214503/benefits2
  0of20snakes20page.html
• 
  
  

19

• Antivenin is made by injecting horses with toxins
  from venomous snakes and then monitored to make
  sure they survive.
• Then after the horse builds up an immunity the
  blood is extracted and processed into antivenin
• http//www.drugs.com/enc/snake-bite.html

20

• The End

21
References

• Abraham, Sathya. "Toxic Snake Venom to Fight
  Human Disease."
  http//www.news.vcu.edu/vcu_view/pages.aspx?nid1
  732
• Clinical Toxicology(2007) 45, 60-64
• Department of Emergency Medicine, University of
  Pennsylvania, Philadelphia, Pennsylvannia, USA
• http//en.wikipedia.org/wiki/Snakes_venom
• http//en.wikipedia.org/wiki/Snakes
• http//library.thinkquest.org/CR0214503/benefits2
  0of20snakes20page.html
• http//jpet.aspetjournals.org/cgi/content/full/285
  /2/490
• http//reptilis.net/serpentes/venom.html
• http//www.drugs.com/enc/snake-bite.html
• http//www.venomdoc.com
• Levy, Paul. "Venomous Snake Goodness An Analysis
  of Snake Venom Toxicity." http//jrscience.wcp.mu
  ohio.edu/fieldcourses03/PapersCostaRicaArticles/Ve
  nomousSnakeGoodn ess.AnA.html
• McDowall, Jennifer. "Snake Venom Bungarotoxins."
  http//www.ebi.ac.uk/interpro/potm/2004_
  6/Page1.htm
• Nalik, Jon. "The Good, the Bad, and the Slimy."
  http//www.usc.edu/hsc/info/pr/hmm/01summer/slimy
  .html
• R. Zug and Carl H. Ernst and Harrison's
  Principles of Internal Medicine and
  www.TheSnake.org http//www.reptileallsorts.com/
  bites-venom.htm
• Shaikh, Din Muhammad and Rukhsana Jokhio. "The
  Potential of the Crude Snake Venom in Treatment
  of Human Breast Cancer with and without
  Combination of Anticancer Drugs."
  http//www.pps.org.pk/PJP/3-1/0720DMShaikh.pdf