Antivenoms and coagulation

Abstract

The treatment of snake envenomations has been a complicated battle for over a century. Since the development of antivenoms, inevitably fatal venoms have decreased to rarely fatal provided that antivenom is administered early. Snake venoms contain many molecules that act directly at the site of the bite, while others set off cascades of reactions leading to cumulative disruptions. A primary example is the disruption on the coagulation cascade. Venom molecules promote or inhibit molecules involved in the hemostatic system causing major disturbances that can lead to detrimental consequences. Although antivenoms have been present for a long time, the production and availability of these snakebite antidotes have fallen short. In recent years, some pharmaceutical companies have halted their production of antivenoms due to unprofitable circumstances, and the stringent regulations to meet safety standards have deterred others from considering taking on such an endeavor. Physicians, scientists, poison control and government administrators must make a profound effort to come together to bring in new ideas that will aid in resolving those troubled issues surrounding antivenoms. The focus of this chapter is to briefly address venom components acting on the hemostatic pathway and the use and concerns involved with the antivenoms utilized to neutralize them.