www.cartoonstock.com

Snake BitesSnake Bites

www.wikipedia.org/snakebites

IntroductionIntroduction◊ 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.

◊ 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/snakevenom, www.mun.ca

Snake VenomSnake 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

◊ 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

http://library.thinkquest.org/CRO214503/benefits%200f%20snakes%20page.html

BenefitsBenefits◊ 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.

◊ 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.

www.bangkokpost.com, http://www.youtube.com/watch?v=WdULbnYylUco

Snake VideoSnake Video

◊ Snake Bite Video◊ Snake Bite Video

VenomVenom

◊ 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

◊ 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

VenomVenom◊ 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.htmhttp://www.reptileallsorts.com/bites-venom.htm

◊ 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.htmhttp://www.reptileallsorts.com/bites-venom.htm

Mechanism of ToxicityMechanism 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 bodyhttp://jrscience.wcp.muohio.edu/fieldcourses03/PapersCostaRicaArticles/

VenomousSnakeGoodness.AnA.htmlhttp://www.reptileallsorts.com/bites-venom.htm

◊ The most common types of enzymes are proteolytic, phospholipases, and hyaluronidases

• Proteolytic Enzymes: digestive properties

• Phospholipases: degrade lipids• Hyaluronidases: speed venom spread

through the bodyhttp://jrscience.wcp.muohio.edu/fieldcourses03/PapersCostaRicaArticles/

VenomousSnakeGoodness.AnA.htmlhttp://www.reptileallsorts.com/bites-venom.htm

Mechanism of ToxicityMechanism of Toxicity

◊ Collagenases◊ Phosphodiesterases◊ Acetylcholinesterase◊ Circulatory System Effects

http://jrscience.wcp.muohio.edu/fieldcourses03/PapersCostaRicaArticles/VenomousSnakeGoodness.AnA.html

◊ Collagenases◊ Phosphodiesterases◊ Acetylcholinesterase◊ Circulatory System Effects

http://jrscience.wcp.muohio.edu/fieldcourses03/PapersCostaRicaArticles/VenomousSnakeGoodness.AnA.html

Mechanism of ActionMechanism 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

◊ 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 ActionMechanism 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

◊ 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 ActionMechanism 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

◊ 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 ActionMechanism 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.pdfhttp://www.usc.edu/hsc/info/pr/hmm/01summer/slimy.html

◊ 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.pdfhttp://www.usc.edu/hsc/info/pr/hmm/01summer/slimy.html

Body ClearanceBody 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

◊ 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

www.funnyhub.com/.../img/snake-bites-foot.jpg

Side EffectsSide Effects

◊ 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

◊ 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

Case Study # 1Case 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

◊ 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 #2Case 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

◊ 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

SummarySummary

◊ 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• Cytotoxichttp://en.wikipedia.org/wiki/Snakeshttp://library.thinkquest.org/CR0214503/benefits%20of%20snakes%20page.html

◊ 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• Cytotoxichttp://en.wikipedia.org/wiki/Snakeshttp://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

◊ 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

www.funnyhub.com/.../img/snake-bites-face.jpg

The EndThe End

ReferencesReferences◊ 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

◊ 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