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Logo BOOMSLANG (TREE SNAKE) SNAKEBITE ANTISERUM

PROPRIETARY NAME:
BOOMSLANG (TREE SNAKE) SNAKEBITE ANTISERUM

DESCRIPTIVE NAME:
BOOMSLANG (TREE SNAKE) SNAKEBITE ANTISERUM (ANTIVENOM)

REGISTRATION NUMBER:
T515 (Act 101/1965)

PHARMACOLOGICAL CLASSIFICATION:
A30.2 ANTIBODIES

SCHEDULING STATUS:
S4

COMPOSITION:
Pepsin-refined immunoglobulins, prepared from the serum of horses that have been hyper-immunised with boomslang (tree snake) Dispholidus typus snake venom.

IDENTIFICATION:
A light yellow to light brown clear liquid.

PHARMACOLOGICAL ACTION:
Neutralises the venom of the boomslang (tree snake).

INDICATIONS:
For the treatment of boomslang snake bite. This serum is only effective against the venom of the boomslang or tree snake and NO OTHER back-fanged snakes.

CONTRA-INDICATIONS:
Significant allergic disease, or a history of an adverse reaction to the injection of serum.

DOSAGE AND DIRECTIONS FOR USE:
N.B. BEFORE INJECTING, CARRY OUT THE INITIAL FIRST AID PROCEDURES AS DETAILED BELOW:–
THE PRESSURE BANDAGE
In all cases of snake bite a broad bandage (preferably a crêpe bandage) should be applied as soon as possible around the limb, covering the bitten area and as much of the limb as possible. This may be supplemented with other material, e.g. a strip torn off a shirt. It should be applied as tightly as one would bind a sprained ankle. The limb must be kept as still as possible by splinting with wood, cardboard, rolled newspaper, or any available rigid material.

GENERAL TREATMENT
Keep the patient quiet and comfortably warm and avoid unnecessary movement. Small amounts of water, tea or coffee may be given and alcohol in moderation if the patient has no difficulty with breathing or swallowing. A patient suffering from a suspected or known boomslang bite, should be kept under observation for up to five days. Boomslang snake venom is haemotoxic, causing continued bleeding due to a coagulation defect, but the bleeding tendency may not develop until the second or third day after the bite.

SERUM TREATMENT
If boomslang bite is suspected, inject TWO ampoules intravenously after a small trial subcutaneous dose at first sign of poisoning (coagulation defect). A trial dose of 0,1 mL of serum diluted 1:10 in water for injection should be injected under the skin. If there is no untoward reaction within half an hour, 0,2 mL of undiluted serum could be given the same way, to be followed, if necessary, by the full dose intravenously if no reaction occurs to this trial dose.

The initial dose of two ampoules should be injected intravenously, the serum should be at room temperature and the injection given very slowly, with the patient recumbent during the injection, and for at least one hour afterwards. The dose of serum required depends on the amount of venom injected by the snake, not on the size or mass of the victim, and should not be reduced in the case of children. If bleeding continues for more than two hours after the first dose, a further injection of one or two ampoules may be given.

SIDE EFFECTS AND SPECIAL PRECAUTIONS:
The injection of even highly purified serum carries a risk of untoward reactions. The commonest is serum sickness which may occur about ten days after the injection but sometimes sooner. It is characterised by itching rashes and sometimes a rise in temperature and joint pains. Proper treatment (antihistaminics, steroids) should alleviate the symptoms.
A rare but far more serious complication is an acute serum reaction (anaphylaxis) with a sudden drop in blood pressure and collapse within a few minutes. The risk of this type of reaction in a healthy person is very slight but those with an allergic disposition, in particular a history of asthma or infantile eczema, should not receive serum unless it is absolutely necessary and then only with the greatest caution. Treatment for this condition includes the injection of adrenalin.

KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT:
None. Treat symptomatically.

PRESENTATION:
10 mL Ampoules packed singly.

STORAGE INSTRUCTIONS:
Store at 2° C to 10° C.

NAME AND BUSINESS ADDRESS OF APPLICANT:
The South African Institute for Medical Research.
Rietfontein, Edenvale, Transvaal.
P.O. Box 28999, Sandringham, 2131

DATE OF PUBLICATION OF THIS PACKAGE INSERT:
undated

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