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Snake Bites. 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
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Snake Bites www.cartoonstock.com
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 it’s relation to Asclepius, the Greek god of Medicine. www.wikipedia.org/snakebites
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 www.wikipedia.org/snakevenom, www.mun.ca
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. http://library.thinkquest.org/CRO214503/benefits%200f%20snakes%20page.html
Snake Video • Snake Bite Video www.bangkokpost.com, http://www.youtube.com/watch?v=WdULbnYylUco
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
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 http://www.rattlesnakebite.org/rattlesnakepics.htm http://www.reptileallsorts.com/bites-venom.htm
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/PapersCostaRicaArticles/VenomousSnakeGoodness.AnA.html http://www.reptileallsorts.com/bites-venom.htm
Mechanism of Toxicity • Collagenases • Phosphodiesterases • Acetylcholinesterase • Circulatory System Effects http://jrscience.wcp.muohio.edu/fieldcourses03/PapersCostaRicaArticles/VenomousSnakeGoodness.AnA.html
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
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?nid=1732
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/rattlesnake.html
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/3-1/07%20DMShaikh.pdf http://www.usc.edu/hsc/info/pr/hmm/01summer/slimy.html
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 it’s 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
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 Side Effects www.funnyhub.com/.../img/snake-bites-foot.jpg
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 patient’s 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
Case Study #2 • 24 year old male zoo employee • Bitten on hand while changing Gaboon Viper’s 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
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/benefits%20of%20snakes%20page.html
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
The End www.funnyhub.com/.../img/snake-bites-face.jpg
References • Abraham, Sathya. "Toxic Snake Venom to Fight Human Disease." http://www.news.vcu.edu/vcu_view/pages.aspx?nid=1732 • 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/benefits%20of%20snakes%20page.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.muohio.edu/fieldcourses03/PapersCostaRicaArticles/VenomousSnakeGoodn 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/3-1/07%20DMShaikh.pdf