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Nursing 2020 Feb;50(2):56-60

Ariel Miller is a nursing student at Sacramento State University in Sacramento, Calif., as well as a wildlife biologist and environmental planner; Bridget Parsh is a professor of nursing at Sacramento State University.

Venomous snakebites are surprisingly common in the US. This article provides an overview of what to do when a patient has been bitten by a North American pit viper, a venomous subset of indigenous snakes. Read More

Methods Mol Biol 2020 ;2068:239-268

Faculty of Medicine, School of Pharmacy, Institute for Drug Research, The Hebrew University of Jerusalem, Jerusalem, Israel.

Snake and spider envenomation have a considerable impact on public health. Their pathology is induced by a variety of toxins composing the venom which induce cytotoxicity to cells of different organs by several cell death pathways. Described in this chapter are methods in vitro used to assess venoms and toxin-induced cell death using mammalian cell cultures. Read More

J Ethnopharmacol 2019 Apr 25;233:218-233. Epub 2019 Jan 25.

National Innovation Foundation-India (Autonomous Body of Department of Science and Technology, Govt. of India), Grambharti, Amarapur, Gandhinagar, Gujarat 382650, India. Electronic address:

Ethnopharmacological Relevance: Ensete superbum (Roxb.) Cheesman. (Family: Musaceae), commonly known as "Wild Banana" is well recorded as popular ethnomedicine for medicinal and nutritional uses by different people and communities native to India, Ethiopia, Thailand, Myanmar and Vietnam. Read More

Int J Biol Macromol 2018 Apr 20;109:664-671. Epub 2017 Dec 20.

Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto-SP, Brazil. Electronic address:

Snake venoms are complex mixtures of organic and inorganic compounds, including proteins belonging to the protease (serine and metalloproteinases), oxidase (L-amino acid oxidases), and phospholipase (especially phospholipases A) enzyme classes. These toxins account for the serious deleterious effects of snake envenomations, such as tissue necrosis, neurotoxicity, and hemorrhage. In addition to their toxic effects, snake venom toxins have served as important tools for investigating the mechanisms underlying envenomation and discovering new pharmacologically active compounds with immunotherapeutic potential. Read More

Toxins (Basel) 2017 12 22;10(1). Epub 2017 Dec 22.

Center for Bioinformatics and Molecular Simulations (CBSM), Universidad de Talca, 3460000 Talca, Chile.

Most snake venom toxins are proteins, and participate to envenomation through a diverse array of bioactivities, such as bleeding, inflammation, and pain, cytotoxic, cardiotoxic or neurotoxic effects. The venom of a single snake species contains hundreds of toxins, and the venoms of the 725 species of venomous snakes represent a large pool of potentially bioactive proteins. Despite considerable discovery efforts, most of the snake venom toxins are still uncharacterized. Read More

Evid Based Complement Alternat Med 2017 21;2017:5748256. Epub 2017 Aug 21.

Laboratório de Tecnologia & Biotecnologia Farmacêutica (TecBioFar), Faculdade de Farmácia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil.

Snakebites are a serious problem in public health due to their high morbimortality. Most of snake venoms produce intense local tissue damage, which could lead to temporary or permanent disability in victims. The available specific treatment is the antivenom serum therapy, whose effectiveness is reduced against these effects. Read More

J Proteomics 2018 02 24;172:173-189. Epub 2017 Aug 24.

Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (CSIC), Jaume Roig 11, 46010, Valencia, Spain. Electronic address:

Mambas (genus Dendroaspis) are among the most feared of the medically important elapid snakes found in sub-Saharan Africa, but many facets of their biology, including the diversity of venom composition, remain relatively understudied. Here, we present a reconstruction of mamba phylogeny, alongside genus-wide venom gland transcriptomic and high-resolution top-down venomic analyses. Whereas the green mambas, D. Read More

Br J Haematol 2017 06 24;177(6):947-959. Epub 2017 Feb 24.

Alistair Reid Venom Research Unit, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, UK.

Snake venoms are mixtures of numerous proteinacious components that exert diverse functional activities on a variety of physiological targets. Because the toxic constituents found in venom vary from species to species, snakebite victims can present with a variety of life-threatening pathologies related to the neurotoxic, cytotoxic and haemotoxic effects of venom. Of the 1·8 million people envenomed by snakes every year, up to 125 000 die, while hundreds of thousands survive only to suffer with life-changing long-term morbidity. Read More

Intern Med J 2017 Feb;47(2):170-176

Department of Epidemiology and Preventative Medicine, Monash Centre of Cardiovascular Research and Education in Therapeutics, Melbourne, Victoria, Australia.

Background: Accidental injury is a major public health problem in developed countries with 20 years elapsed since a national overview of venomous bites undertaken in Australia.

Aim: Provide the first contemporary epidemiological insight into venomous injuries based on demographics and geography nationally in Australia in the period 2000-2013.

Methods: An analysis of national hospitalisation and mortality data was undertaken to examine the incidence of injury and death due to envenoming in Australia. Read More

Toxins (Basel) 2016 09 7;8(9). Epub 2016 Sep 7.

Venom Evolution Lab, School of Bioloigical Sciences, University of Queensland, St Lucia QLD, 4072 Brisbane, Australia.

The "function debate" in the philosophy of biology and the "venom debate" in the science of toxinology are conceptually related. Venom systems are complex multifunctional traits that have evolved independently numerous times throughout the animal kingdom. No single concept of function, amongst those popularly defended, appears adequate to describe these systems in all their evolutionary contexts and extant variations. Read More

Curr Pharm Des 2016 ;22(34):5270-5293

Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

The snake is the symbol of medicine due to its association with Asclepius, the Greek God of medicine, and so with good reasons. More than 725 species of venomous snakes have toxins specifically evolved to exert potent bioactivity in prey or victims, and snakebites constitute a public health hazard of high impact in Asia, Africa, Latin America, and parts of Oceania. Parenteral administration of antivenoms is the mainstay in snakebite envenoming therapy. Read More

J Venom Anim Toxins Incl Trop Dis 2015 24;21:35. Epub 2015 Sep 24.

Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Avenida do Café, s/n, Ribeirão Preto, SP CEP 14040-903 Brazil.

Snake venom galactoside-binding lectins (SVgalLs) comprise a class of toxins capable of recognizing and interacting with terminal galactoside residues of glycans. In the past 35 years, since the first report on the purification of thrombolectin from Bothrops atrox snake venom, several SVgalLs from Viperidae and Elapidae snake families have been described, as has progressive improvement in the investigation of structural/functional aspects of these lectins. Moreover, the advances of techniques applied in protein-carbohydrate recognition have provided important approaches in order to screen for possible biological targets. Read More

Int J Health Policy Manag 2015 Apr 4;4(7):447-57. Epub 2015 Apr 4.

Athena Institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands.

Background: Snakebite has recently been declared a global public health emergency. Empirical data showing the true burden of snakebite is lacking. Treatment with specific antivenoms is considered the only cure. Read More

Pak J Pharm Sci 2015 May;28(3):1009-13

Department of Agricultural Sciences, University of Haripur, Pakistan.

Pistacia integerrima with a common name crab's claw is an ethnobotanically important tree native to Asia. Traditionally plant parts particularly its galls have been utilized for treatment of cough, asthma, dysentery, liver disorders and for snake bite. Plant mainly contains alkaloids, flavonoids, tannins, saponins and sterols in different parts including leaf, stem, bark, galls and fruit. Read More

Emerg Nurse 2015 Feb;22(9):24-9

University of South Florida College of Nursing, Tampa, Florida, United States.

Only one species of venomous snake, the adder, is indigenous to the UK, but many people keep venomous snakes as pets and others travel to places, such as the United States, where a wider variety of venomous snakes can be found. Emergency nurses should therefore be prepared to treat bite wounds caused by venomous and non-venomous snakes. This article offers an overview of the most common forms of envenomation in the UK and makes recommendations for the clinical care of people who have sustained snake bites. Read More

J Clin Toxicol 2014 Jan;4(1):1000181

Department of Biological Sciences, University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA.

Snake venom toxins are responsible for causing severe pathology and toxicity following envenomation including necrosis, apoptosis, neurotoxicity, myotoxicity, cardiotoxicity, profuse hemorrhage, and disruption of blood homeostasis. Clinically, snake venom toxins therefore represent a significant hazard to snakebite victims which underscores the need to produce more efficient anti-venom. Some snake venom toxins, however, have great potential as drugs for treating human diseases. Read More

Biomed Res Int 2014 12;2014:196754. Epub 2014 Mar 12.

Centro de Estudos de Biomoléculas Aplicadas à Saúde, (CEBio), Fundação Oswaldo Cruz, Fiocruz Rondônia e Departamento de Medicina, Universidade Federal de Rondônia (UNIR), Porto Velho, RO, Brazil.

L-amino acid oxidases are enzymes found in several organisms, including venoms of snakes, where they contribute to the toxicity of ophidian envenomation. Their toxicity is primarily due to enzymatic activity, but other mechanisms have been proposed recently which require further investigation. L-amino acid oxidases exert biological and pharmacological effects, including actions on platelet aggregation and the induction of apoptosis, hemorrhage, and cytotoxicity. Read More

Asian Pac J Trop Biomed 2013 Aug;3(8):668-72; discussion 672

Origin of ancient Indian toxicology can be dated back to vedic literature. Toxins of both animate and inanimate world were very well understood during the era. Rig and Atharva vedic texts describe such details. Read More

Mini Rev Med Chem 2013 Jul;13(9):1348-56

Lorane Izabel da Silva Hage Melim Faculdade Seama Av. Ver. José Tupinambá de Almeida, 1201, Jesus de Nazaré, 68908-170, Macapá, AP, Brasil.

Many plants are used in traditional medicine as active agents against various effects of snake bites. Phospholipase A2 enzymes are commonly found in venoms of snakes of the Viperidae and Elaphidae families, which are their main components. This article presents an overview of inhibitors isolated from plants, which show antiophidian properties. Read More

Rev Salud Publica (Bogota) 2012 Oct;14(6):1005-13

Departamento de Toxicología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia,

Objective: This study was motivated as only partial knowledge is available (regarding national statistics) about accidents caused by poisonous animals in Colombia. The study was aimed at establishing a base-line concerning accidents reported by phone to the Toxicology Management and Research Information Centre (CIGITOX) from all over Colombia; such data was taken from the centre's data-base following its five years of being in operation(2006-2010).

Methods: This was a descriptive, retrospective study, taking information from the CIGITOX database over a five-year period (2006-2010); Excel 2011was used for statistical analysis. Read More

Orv Hetil 2012 Jul;153(28):1092-105

Debreceni Egyetem Farmakognózia Részleg Debrecen.

Consequences of bites by the Common adder (Vipera berus) were reviewed in this study. Patients bitten by snakes from different populations may develop variable symptoms due to geographical venom variation. The correct diagnosis of snake bites and the knowledge of the distribution of venomous snake taxa have a crucial impact on snake bite therapy. Read More

Public Health 2012 Jun 10;126(6):507-17. Epub 2012 May 10.

School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand.

Introduction: This narrative review was carried out to collate the work of researchers on health-seeking behaviour in Pakistan, to discuss the methods used, highlight the emerging themes and identify areas that have yet to be studied.

Study Design: Review.

Methods: An overview of studies on health-seeking behaviour in Pakistan, found via searches on scholarly databases intended to locate material of medical and anthropological relevance. Read More

Bioinformation 2012 6;8(1):48-57. Epub 2012 Jan 6.

Natural inhibitors occupy an important place in the potential to neutralize the toxic effects caused by snake venom proteins and enzymes. It has been well recognized for several years that animal sera, some of the plant and marine extracts are the most potent in neutralizing snake venom phospholipase A(2) (svPLA(2)). The implication of this review to update the latest research work which has been accomplished with svPLA(2) inhibitors from various natural sources like animal, marine organisms presents a compilation of research in this field over the past decade and revisiting the previous research report including those found in plants. Read More

J Vet Emerg Crit Care (San Antonio) 2011 Oct;21(5):461-70

Department of Small Animal Clinical Sciences, University of Florida Small Animal Hospital, Gainesville, FL 32610, USA.

Objective: To provide a review and update on the medical management of pit viper envenomation in dogs.

Etiology: Pit viper snake (Crotalidae) envenomation in dogs is a common emergency in the United States. At least 50 enzymes contribute to snake venom potency that causes soft tissue damage, vasculotoxicity, coagulopathy, cytotoxicity, and necrosis. Read More

Orv Hetil 2011 Oct;152(41):1661-5

Miskolci Semmelweis Ignác Egészségügyi Központ és Egyetemi Oktató Kórház Nonprofit Kft. Bőrgyógyászati Osztály Miskolc Jókai Mór u. 4. 3525.

The common European viper is widespread throughout Europe. In Hungary it can be found mainly in the Zemplén Mountains, on the upper course of the Tisza River, and Zala and Somogy counties. Viper's bite is one of the rarest injuries that requires emergency medical care. Read More

Inflamm Allergy Drug Targets 2011 Oct;10(5):343-57

Immunochemistry Laboratory, Butantan Institute, São Paulo, Brazil.

This review summarizes the key contributions to our knowledge regarding the immune response induced by snake venom toxins, focusing particularly on the production of antibodies and their venom-neutralizing effects. We cover the past and present state of the art of anti-snake venom production, followed by an overview of the venomous snakes and their venoms. The toxic properties of relevant snake venom toxins are approached in some details, with particular emphasis on the molecular domains responsible for binding to cells or plasma components in victims. Read More

Biochemistry (Mosc) 2010 Jan;75(1):1-6

Department of Studies in Biochemistry, University of Mysore, Manasagangothri, Mysore, 570006, India.

In this review, we have compiled the data on pharmacological activities associated with endogenous purine release related enzymes-nucleases (DNases, RNases, and phosphodiesterases). The results of studies on toxic effects of these enzymes, emphasizing the future directions in this field, are summarized. One of the major problems facing toxicologists is the identification and characterization of specific venom nucleases since they share similar substrate specificities and biochemical properties. Read More

Coll Antropol 2009 Dec;33 Suppl 2:93-8

Department for Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Read More

Am Fam Physician 2009 Oct;80(8):793-802

Women's and Children's Hospital, North Adelaide, South Australia, Australia.

About 4,000 to 6,000 venomous snakebites occur each year in the United States. Although these envenomations (also known as envenomings) are rarely fatal, about 70 percent require antivenom therapy. Few evidence-based guidelines are available for the management of envenomation. Read More

Pediatr Emerg Care 2006 Nov;22(11):740-6; quiz 747-9

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.

Antidotes are playing an increasing role in therapy for pediatric poisonings. Although initial response to all pediatric poisonings begins with basic stabilization, knowledge of specific antidotes, their mechanisms of action, safety profile in pediatrics, and dosing regimens can be life-saving for pediatric victims of nerve gas exposure, acetaminophen toxicity, methanol and ethylene glycol ingestion, and snakebites. This article presents an overview of the pathophysiology, symptoms, antidotes, and emergency management of these toxicological emergencies. Read More

Med Trop (Mars) 2006 Jun;66(3):215-20

l'IRD, CP 9214, La Paz, Bolivie.

Venomous animals that are able to innoculate or inject venom and poisonous animals that cannot inject venom but are toxic when ingested belong to all zoological groups. They can be encountered worldwide in any ecosystem on land and at sea but they are more common and more dangerous in tropical areas. This first article of a series to appear in the next issues of Medecine Tropicale presents an overview of species involved in envenomations and poisonings. Read More

Indian J Exp Biol 2002 Dec;40(12):1353-8

Laboratory of Toxinology & Experimental Pharmacodynamics, Department of Physiology, University of Calcutta 92, A P C Road, Kolkata 700 009, India.

Snake bite injuries and death are socio-medical problems of considerable magnitude. In India a large number of people suffer and die every year due to snake venom poisoning. Snake venom, though greatly feared, is a natural biological resource, containing several components that could be of potential therapeutic value. Read More

Ther Drug Monit 2000 Feb;22(1):65-8

Toxinology Department, Women's and Children 's Hospital, North Adelaide, Australia.

Venomous and poisonous animals are a significant cause of global morbidity and mortality. This Seminar will cover selected aspects of these animals, their venoms/poisons, and their clinical impact on humankind, from a global perspective, but with a distinctive Australian flavor and a clinical emphasis. Venomous snakes are found throughout most of the world, including many oceans, and have evolved a variety of highly effective toxins and methods of delivery. Read More

Ned Tijdschr Geneeskd 1998 Dec;142(51):2773-7

Havenziekenhuis en Instituut voor Tropische Ziekten, afd. Inwendige Geneeskunde, Rotterdam.

The management of poisonous snake bites includes first aid and clinical medical treatment. First aid consists of reassurement of the patient, immobilisation of the bitten limb and rapid transport to the nearest hospital to monitor the vital functions. In no case suction, incision or tight bandages should be applied. Read More

J Emerg Med 1991 Nov-Dec;9(6):497-502

Department of Emergency Medicine, Denver General Hospital, Colorado 80204.

As more people travel to the oceans for sport diving and other marine related activities, the incidence of marine envenomations has risen. This article is designed to give the emergency physician an overview of varying marine envenomations, their clinical presentation, and recommended treatment. Part 1 of this article addresses general wound management and vertebrate envenomations. Read More

Kidney Int 1989 Mar;35(3):891-907

Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Acute renal failure complicates the course in 5% to 30% of victims of severe viper poisoning. No consensus exists on the single mechanism causing acute renal failure after viper bite. It is known, however, that viper venom induces several clinical abnormalities that favor the development of acute renal failure. Read More