Irritant poison — mainly produce inflammation on the site of contact, especially in the gastrointestinal tract, respiratory tract, and skin.
When a poison has a systemic effect and death ensues because of it, then it is classified as a poison affecting that system most, for example, cardiac poison or cerebral poison, or a spinal poison.
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Inorganic Irritants
Organic Irritants
Mechanical Irritants
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Snake venom is the %%poisonous secretion%% %%ejected from the poison apparatus%% (modified parotid gland) of a poisonous snake, during the act of biting.
Snake venoms are usually clear and amber-colored fluid when fresh.
They are poisonous only when injected by a needle or by bite of a snake.
The venom is non-poisonous when taken orally.
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They have no poison apparatus.
They possess 4 longitudinal rows of teeth in upper jaw and 2 rows in lower jaw.
Tail is not compressed.
Ventral shields are small/moderately large.
Head scales are usually larger and without any special features.
Fangs are short and solid.
These are not nocturnal.
The bite marks show more than two teeth markings
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Systematic Envenomation
Hemostatic disturbances; spontaneous systemic bleeding.
Cardiovascular abnormalities: shock, hypotension, abnormal electrocardiogram, arrhythmia, cardiac failure, pulmonary edema.
Neurotoxicity.
Generalized rhabdomyolysis.
Impaired consciousness of any cause.
In patients with definite signs of local envenomation, the following indicate significant systemic envenomation:
Severe Local Envenoming
Local swelling involving more than half of the bitten limb, or associated with extensive blistering or bruising, especially in patients bitten by species whose venoms are known to cause local neurosis. Bites on digits carry a high risk of necrosis.
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There is no absolute contraindication to antivenom in patients with life-threatening systemic envenomation.
Patients with an atopic history and those who had reactions to equine antiserum on previous occasions have an increased risk of severe reactions.
In case of pretreatment with subcutaneous adrenaline and intravenous antihistamine and corticosteroids may prevent or diminish the reaction.
Rapid desensitization is not recommended.
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Local Envenomation
Polyspecific/Polyvalent Antivenom
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Always perform serum sensitivity test (test dose) before giving it.
The skin test procedure
The desensitization procedure
According to another view, skin testing is not necessary, but adrenaline should be injected subcutaneously as premedication with a dose of a systemic corticosteroid.
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