Agkistrodon piscivorus immune fab antivenin (ovine)

Agkistrodon piscivorus immune fab antivenin (ovine) Uses, Dosage, Side Effects, Food Interaction and all others data.

Agkistrodon piscivorus immune fab antivenin (ovine) is derived and purified immunoglobulin fragments obtained from other domestic animals such as sheep previously immunized with Agkistrodon piscivorus (Cottonmouth or Water Moccasin snake). The final purified antivenin product is obtained by mixing other different monospecific snake antivenins and isolating the antivenin of interest through fractionation and chromatography techniques. It is intravenously (IV) administered to limit/prevent systemic toxicity .

Approximately 99% of all venomous snake bites in the United States are caused by Crotalidae, also known as pit vipers. In North America, members of the family Crotalidae belong to three genera: the rattlesnakes (Crotalus and Sistrurus spp.) and the copperheads and cottonmouth water moccasins (Agkistrodon spp.) .

The cottonmouth, Agkistrodon piscivorus, is a large, venomous snake in the pit viper subfamily (Crotalinae). As the only semi-aquatic viper species, cottonmouth snakes are strong swimmers and are frequently found in or near water .

Agkistrodon piscivorus immune fab antivenin (ovine)
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Agkistrodon piscivorus immune fab antivenin (ovine)
Generic	Agkistrodon piscivorus antivenin
Agkistrodon piscivorus antivenin Other Names	Agkistrodon piscivorus immune fab antivenin (ovine)
Type
Groups	Approved, Experimental
Therapeutic Class
Manufacturer
Available Country
Last Updated:	September 19, 2023 at 7:00 am

Uses

Agkistrodon piscivorus immune fab antivenin (ovine) is a mixture of antibodies used to treat venomous snake bites from the Crotalinae family (pit vipers).

CROFAB is a sheep-derived antivenin indicated for the management of adult and pediatric patients with North American crotalid envenomation .

Agkistrodon piscivorus immune fab antivenin (ovine) is also used to associated treatment for these conditions: Venom poisoning caused by Agkistrodon piscivorus

How Agkistrodon piscivorus immune fab antivenin (ovine) works

CROFAB is a mixture of 4 different monospecific antivenoms derived from serum of healthy sheep immunized with one of the following North American snake venoms: C. atrox (Western diamondback rattlesnake), C. adamanteus (Eastern diamondback rattlesnake), C. scutulatus (Mojave rattlesnake), or A. piscivorus (cottonmouth or water moccasin) .

CROFAB consists of venom-specific Fab fragments of immunoglobulin G (IgG) that work by binding to and neutralizing venom toxins, facilitating their redistribution away from target tissues and their elimination from the body .

CROFAB contains only the Fab fragments from ovine-derived immunoglobulins. The enzyme papain is used to cleave the IgG antibody, creating 2 separate Fab fragments and 1 Fc fragment. After the cleavage step, another protein binds to the Fc fragments, which are not essential for binding snake venom, allowing the pure Fab fragments to be recovered. The Fab fragments of an immunoglobulin contain the variable regions that recognize and bind to specific antigens .

Toxicity

ED50: 4 (mg antivenin/mg venom)

Most common adverse reactions (incidence ≥5% of subjects) are urticaria, rash nausea, pruritus, and back pain .

Severe hypersensitivity reactions may occur with the use of CROFAB. In case of acute hypersensitivity reactions, including anaphylaxis and anaphylactoid reactions, discontinue infusion and institute appropriate emergency treatment .

CROFAB contains purified immunoglobulin fragments from the blood of sheep that have been immunized with snake venoms. Injection of heterologous animal proteins can lead to severe acute and delayed hypersensitivity reactions (late serum reaction or serum sickness) and a possible febrile (fever) response to immune complexes formed by animal antibodies and neutralized venom components .

The papain enzyme is used to cleave antibodies into fragments during the processing of CROFAB, and negligible amounts of papain or inactivated papain residues may be present. Patients allergic to papain, chymopapain, other papaya extracts, or the pineapple enzyme, bromelain, may also have an allergic reaction to CROFAB. Certain dust mite allergens and some latex allergens share antigenic structures with papain and patients with these allergies may be allergic to papain .