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Other Antitoxic Sera
Polyvalent antivenin useful against scorpion stings.First specific treatment to neutralize toxin from Centruroides scorpion stings, particularly Centruroides sculpturatus in the United States; children and infants are more likely than adults to have severe stings and resulting symptoms and hospitalization.Derived from equine plasma; early and delayed hypersensitivity reactions are possible.
Anascorp Intravenous Inj Pwd F/Sol
The initial dose is 3 vials of antivenin diluted to a total volume of 50 mL normal saline and administered IV over 10 minutes. Additional doses of 1 vial of antivenin diluted to a total volume of 50 mL normal saline and administered IV over 10 minutes may be given at 30- to 60-minute intervals as needed. Data from use in Mexico and Arizona, including data in critically ill children (age 6 months to 18 years) from a double-blind, placebo-controlled study , suggest that use of the antivenin in most patients can resolve significant clinical toxicity within about 4 hours after treatment.
No maximum dosage information can be definitely assigned at this time.
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
Scorpion antivenin is administered intravenously by infusion.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Do not use if the solution is turbid.
Reconstitution:Reconstitute each vial of scorpion antivenin with 5 ml of sterile normal saline.Mix by swirling gently.If using more than one vial, combine the contents of each vial promptly.Further dilute dose to a total volume of 50 ml with sterile normal saline (0.9% NaCl injection).Discard any partially used vials.Intravenous infusion:Infuse dose intravenously over 10 minutes.Monitor patient closely during and up to 60 minutes following the infusion completion.
Anascorp:- Discard unused portion. Do not store for later use.- Do not freeze- Store at 77 degrees F; brief exposure up to 104 degrees F does not adversely affect product
Hypersensitivity reactions, including anaphylaxis, may occur following administration of scorpion antivenin. Therefore the administration of antivenin requires a specialized care setting and the patient should be hospitalized if possible. The product is derived from the blood of healthy horses immunized with venom from Centruroides scorpions; therefore, patients with equine protein hypersensitivity or patients who have received previous therapy with equine antivenom/antitoxin may be at higher risk for anaphylaxis. Patients should be monitored for signs of hypersensitivity reactions and emergency medications such as epinephrine, corticosteroids, and diphenhydramine should be readily available. The infusion should be terminated and emergency medical care instituted if hypersensitivity reactions develop. Patients should also be monitored for delayed allergic reactions (serum sickness). Scorpion antivenin carries a risk of transmitting infection, such as from viruses, due to the equine source of the product.
Scorpion antivenin contains trace amounts of cresol and should be avoided in patients with cresol hypersensitivity; localized reactions and general myalgias have been reported with the use of cresol as an injectable excipient.
Scorpion antivenin is classified as a FDA pregnancy risk category C. It is not known whether scorpion antivenin causes fetal harm when administered to a pregnant woman and animal reproduction studies have not been conducted. Scorpion antivenin should only be administered to a pregnant woman if the benefit clearly outweighs the risk.
It is not known whether scorpion antivenin is excreted in breast milk; caution should be used when administering to a breast-feeding woman. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally administered drug, health care providers are encouraged to report the adverse effect to the FDA.
serum sickness / Delayed / 0.5-0.5anaphylactoid reactions / Rapid / Incidence not known
ocular inflammation / Early / Incidence not knownhypoxia / Early / Incidence not knownataxia / Delayed / Incidence not knownpalpitations / Early / Incidence not knownlymphadenopathy / Delayed / Incidence not known
vomiting / Early / 4.7-4.7fever / Early / 4.1-4.1rash / Early / 2.7-2.7nausea / Early / 2.1-2.1pruritus / Rapid / 2.0-2.0headache / Early / 1.9-1.9rhinorrhea / Early / 1.8-1.8myalgia / Early / 1.6-1.6fatigue / Early / 1.6-1.6cough / Delayed / 1.4-1.4diarrhea / Early / 1.3-1.3lethargy / Early / 1.1-1.1
There are no drug interactions associated with Scorpion Antivenin, Antivenin Centruroides sculpturatus Equine products.
The clinical consequences of scorpion envenomation are the result of ion channel specific toxins present in the venom which stimulate action potentials throughout the peripheral nervous system. Scorpion antivenin is composed of venom specific F(ab')2 fragments of immunoglobulin G. These fragments bind and neutralize the toxins allowing for redistribution away from target tissues and elimination from the body.
Scorpion antivenin is administered intravenously. In clinical trials, 95—100% of patients responded to scorpion antivenin with relief of systemic symptoms in less than four hours after initiating treatment. Scorpion antivenin is standardized for potency in mice in terms of its LD50 neutralizing capacity per mL. Based on this assay system, the reconstituted contents of each vial (5 mL) will neutralize approximately 150 LD50 of Centruroides scorpion venom and contains no more than 120 mg of protein. In a pharmacokinetic study, 47.5 mg of scorpion antivenin was administered to eight healthy adult volunteers and blood samples were collected over 21 days. The following pharmacokinetic parameters were reported (mean +/- standard deviation): area under the curve (AUC) 706 +/- 352 mcg/ml x hr, clearance 83.5 +/- 38.4 ml/hr, half-life 159 +/- 57 hrs, and volume of distribution at steady-state 13.6 +/- 5.4 L.