TOXICITY AND DRUG MANAGEMENT OF VENOMOUS SNAKEBITE; ARE CHILDREN AND ADULTS EQUAL IN RISK OF DEATH?
*Azikiwe C. C. A., Nwozor C. M. and Ifezulike C. C.
Snakebite and envenomation are silent public health issues and constitutes a major public health challenge in many parts of the world. According to World Health Organization (WHO), 4.5-5.4 million people a year are bitten by snakes, 1.8-2.7 million of them develop clinical illness (envenomation) after snakebite, and death toll could range from 81,000 to 138,000. Four families of venomous snakes are found in Nigeria. They are Viperidae, Elapidae, Colubridae, and Actraspididae. Previous works and research findings on this subject were accessed through Google Search, PubMed, and Wikipedia websites. In addition standard textbooks on Pharmacology were consulted. All these sources provided necessary information for this review. There are different categories of snake venom. They are cytotoxins, hemorrhagins, anti-clotting agents, myotoxins, and neurotoxins. Signs and symptoms of snakebite vary according to the species responsible for the bite, size, age, and the amount of venom injected. A venomous snakebite usually leaves two clear puncture marks. Some of the symptoms are: vomiting, nausea, dizziness, weakness, prostration, bleeding, shock, hypotension, myalgia, stiffness, dark-colored urine, and paralysis. The mainstay of treatment is the use of antivenom (monovalent or polyvalent). Other treatment options involve antitetanus toxin administration, analgesics, and antibiotics. While adults are more occupationally exposed to more bites/envenomation, children are more at risk of death due to hypovolaemia, shock, paralysis and other effects of endotoxins.
Keywords: Snakebite, Antivenom, Adults, Children, Envenomation. Toxicity.
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