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| Primary information |
|---|
| ID | 15258 |
| Therapeutic ID | Th1578 |
| Protein Name | Coral snake (micrurus fulvius) immune globulin antivenin (equine) |
| Sequence | NA
|
| Molecular Weight | NA |
| Chemical Formula | NA |
| Isoelectric Point | NA |
| Hydrophobicity | NA |
| Melting point | NA |
| Half-life | The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins [FDA Label, L2176] obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG formulations demonstrate an intermediate distribution half-life ranging from 5.22 +/- 0.98 hours to 5.98 +/- 0.67 hours and an elimination half-life ranging from 42.66 +/- 2.04 hours to 46.4 +/- 4.8 hours in a rabbit model [A32480]. |
| Description | North American Coral Snake Antivenin (Equine) is a horse-derived antivenin indicated for the treatment of envenomation caused by North American coral snake bites. It is intravenously administered so that the antivenin binds to and neutralizes coral snake venom. The antivenin is a refined, concentrated, and lyophilized preparation of serum globulins obtained by fractionating blood from healthy horses that have been immunized with eastern coral snake (Micrurus fulvius fulvius) venom [FDA Label]. Prior to lyophilization, the product contains 0.25% phenol and 0.005% thiomerosal (mercury derivative) [FDA Label]. |
| Indication/Disease | This particular antivenin is indicated only for the treatment of envenomation caused by bites from Eastern coral snakes (Micrurus fulvius fulvius) and Texas coral snakes (Micrurus fulvius tenere) [FDA Label, L2176]. The agent will not neutralize the venom of Arizona (Sonoran) coral snakes (Micruroides euryxanthus) or that of South American species [FDA Label, L2176]. |
| Pharmacodynamics | North American Coral Snake Antivenin (Equine) is standardized for potency in mice in terms of its LD50 neutralizing capacity per milliliter as determined by intravenous injection of a graded series of mixtures of North American Coral Snake Antivenin (Equine) with M. f. fulvius venom [FDA Label, L2176]. Based on this assay system, the reconstituted contents of each vial (10 mL) will neutralize about 250 mouse LD50 or approximately 2 mg of M. f. fulvius venom [FDA Label, L2176]. |
| Mechanism of Action | North American Coral Snake Antivenin (Equine) is a preparation of serum globulins obtained by fractionating blood from healthy horses that have been immunized with eastern coral snake (Micrurus fulvius fulvius) venom [FDA Label, L2176]. When the antivenin is appropriately administered intravenously, it essentially functions like an injection of antibodies that directly bind to and neutralize coral snake venom that has entered the bloodstream due to any kind of coral snake bite [FDA Label, L2176]. |
| Toxicity | Patients sensitive to antivenin or horse serum may develop anaphylaxis [FDA Label]. Therefore, it is essential that prior to any antivenin administration a proper skin test be performed, interpreted, and therapy modified if indicated [FDA Label]. Anaphylaxis seen with antivenins of equine origin may result in an immediate reaction (shock) usually occurring within 30 minutes [FDA Label]. Signs and symptoms may develop before the needle of administration is even withdrawn from the patient and can include apprehension, flushing, itching, urticaria; edema of the face, tongue, and throat; cough, dyspnea, cyanosis, vomiting, collapse, and possibly even cardiac arrest or death [FDA Label]. Constant attendance and observation for untoward response is mandatory whenever horse serum is administered intravenously so that, should such occur, injection may be discontinued and appropriate treatment instituted immediately [FDA Label]. Even if it is appropriate for a patient to be administered the antivenin, the most common adverse reactions observed after treatment with the agent has been anaphylaxis and serum sickness, vomiting, and abdominal pain [FDA Label]. LD50 values are available for animal models such as the rat, in which the oral LD50 is documented to be 317 mg/kg and the dermal LD50 as 525 mg/kg [MSDS]. |
| Metabolism | The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins [FDA Label, L2176] obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such IgG components undergo much catabolism at the gut and liver in a mouse model [A32480]. Any such IgG molecules with intact carbohydrate containing Fc portions may also experience carbohydrate-specific uptake mechanisms associated with mononuclear phagocyte activity in the liver and other organs [A32480]. Additionally, although it has been observed that the liver and spleen demonstrate the highest IgG catabolism activity in the rat model on a weight basis, in terms of total catabolism, the peripheral tissues, skin, and muscle play the dominant role, indicating that the catabolism of antibodies may occur all throughout the body system [A32480]. |
| Absorption | As the antivenin is essentially an emergency antivenom medication that is administered intravenously in hopes of eliciting an as immediate as possible coral snake venom neutralization in a patient's bloodstream, it is generally assumed that the emergency injection is absorbed entirely. |
| The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins [FDA Label, L2176] obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG antivenoms generally demonstrate a lower volume of distribution in comparison to antivenoms comprised of Fab or F(ab')2 fragments and has been known to potentially exist within the range of 162 +/- 1.9 mL/kg in a rabbit model [A32480]. |
| Clearance | The formal prescribing information for this antivenin describes itself as a preparation containing serum golbulins [FDA Label, L2176] obtained from the fractionated blood of health horses immunized with the necessary venom. If the term 'serum globulins' is taken to mean that this antivenin consists of whole IgG immunoglobulin molecules, then various reviews of antibody preparations suggest that such equine IgG formulations demonstrate a rate of clearance ranging anywhere from 0.36 +/- 0.06 mL/h/kg to 5.46 +/ 0.6 mL/h/kg [A32480]. |
| Categories | Antivenin |
| Patents Number | NA |
| Date of Issue | NA |
| Date of Expiry | NA |
| Drug Interaction | NA |
| Target | NA |
| Brand Name | North American Coral Snake Antivenin (Equine) |
| Company | Wyeth Pharmaceuticals Llc, a Subsidiary of Pfizer Inc. |
| Brand Description | Wyeth Pharmaceuticals Llc, a Subsidiary of Pfizer Inc. |
| Prescribed For | Intravenous |
| Chemical Name | 250 [arb'U]/10mL |
| Formulation | NA |
| Physical Appearance | he most common adverse reactions observed after treatment with North American Coral Snake Antivenin (Equine) were anaphylaxis and serum sickness, vomiting, and abdominal pain. Because these reactions were reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency reliably or to establish a causal relationship to drug exposure. |
| Route of Administration | North American Coral Snake Antivenin (Equine) is a sterile lyophilized powder for solution for injection containing serum globulins obtained by fractionating blood from healthy horses that have been immunized with eastern coral snake (Micrurus fulvius fulvius) venom. Prior to lyophilization, the product contains 0.25% phenol. |
| Recommended Dosage | North American Coral Snake Antivenin (Equine) is indicated only for the treatment of envenomation caused by bites of North American coral snakes - Micrurus (including the eastern and Texas varieties). |
| Contraindication | NA |
| Side Effects | NA |
| Useful Link 1 | Link |
| Useful Link 2 | Link |
| Remarks | NA |