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RE Antivipmyn
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by Rabies on July 17, 2005
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Hi
Antivipmyn has been under going trials for the USA market, possibly due to the high costs of CroFab (whether Antivipmyn stays as cheap as it is in Mexico is a different matter). CroFab is fragmented protien and so tends to be excreted quicker from the body as the older Wyeth, there for requiring larger dosages over a longer period to nuteralize the venom.Its been stated in press releases that some patients have gone into relapse some weeks later due CroFab having this problem, as stated in the Arizona Daily Star "So, we started seeing this re-envenomation phenomenon two weeks later - there was enough venom left to re-envenomate the patient," Figge said. "People would start bruising again, they'd have clotting problems, and in some cases, the pain would return, and they'd be back in the hospital" Surely even after this period of time AV such such as Wyeth and Antivipmyn would have been excreted leaving the patient vunerable to possible re envenomation? Can this relapse be due to inadequate amounts of CroFab being administered in the first place? Also, how long do the enzymes and protiens found in venom stay active in the victim, surely after a few weeks or so the body has managed to dispose of the remaining venom? Thanks
Also these clotting problems can be to the patient being unable to reproduce the missing factors in sufficient numbers and there for this "relapse" arises and may not be due to a direct affect from venom.
John
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RE: RE Antivipmyn
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by Phobos on July 17, 2005
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John:
Try to get this reference paper:
Annals of Emergency Medicine, Vol 37, #2 Pages 189-201
"Recurrence Phenomena After Immunogoblin Therapy For Snake Envenomations. Parts 1 & 2
I know the authors personally and spoke to them about this problem. They reason for wanting Antivipmyn is not cost related at all to the cost but strictly effectiveness. They believe that venom is trapped in the tissue because of edema and local tissue damage. As the inital therapy reduces these effect, capillary and lymphatic vessels regenerate releasing this venom into the blood stream causing this rebound envenomation.
CroFab not only clears the system fast, it is also not very effective against many of the crotalids. It has a low neutralization factor with Helleri & Molossus to name two.
Look at the list of species that Antivipmyn is effective against, Dr. Boyer said to me (not an exact quote) That she was shocked at how effective it was with no side effects recognized. Sorry some of these names are local or Spanish but you get the idea.
· Crotalus
· Rattlesnake
· Hognose viper
· Tziripa
· Saye Cascabel
· Cascabel tropical
· Shunu
· Tzab-can
· Bothrops
· Caissaca
· Nauyaca
· Cuatro Narices
· Barba amarilla
· Terciopelo
· Equis
· Mapana
· Jararaca
· Toboba
· Cola de hueso
· Vibora de arbol
· Vibora verde
· Nauyaca real
· Nauyaca de frio
· Nauyaca chatilla
· Palanca
· Palanca lora
· Palanca loca
· Vibora sorda
· Tepoch
· Nascacuati
· Cornezuelo
· Torito
· Cac-can
· Agkistrodon
· Cantil
· Copperhead
· Cottonmouth
· Zolcuate
· Moccasin
· Cantil de agua
· Castellana
· Cmcoatl
· Metapil
· Puchucuate
· Volpoch
· Sistrurus
· Massasauga
· Pygmy rattlesnake
· Cascabel de neve placas
· Lachesis
· Lora machaco
· Cascabel muda
· Rieca
· Verrugoso
· Sururucucu
· Lorita
· Patoco
· Patoquillo
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RE: RE Antivipmyn
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by LarryDFishel on July 17, 2005
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Phobos,
Something you might want to point out to Dr. Boyer: My spanish is a bit sketchy, but I can read enough of it to say that in at least some cases on that list they are giving for a species:
1) Latin genus name
2) English common name (in one case two of them)
3) Several local spanish common names.
The list may appear several times as long as the actual number of species it represents... There are quite a few spanish names there that I don't know, so it's possible that it's just the ones I know that are repeated.
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RE: RE Antivipmyn
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by Phobos on July 17, 2005
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Hi Larry:
Dang, I forgot to mention where the list came from, not Dr. Boyer but the Miami Dage "Venom 1" site, which seems to be borrowed from the Bioclon perscribing circular.
http://www.miami-dadefirerescue.com/modules/AMS/article.php?storyid=13
Al
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RE: RE Antivipmyn
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by LarryDFishel on July 17, 2005
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Thanks for the link.
Meanwhile, after posting my response, I was intrigued an decided to do a little searching.
For example, the list at www.miami-dadefirerescue.com gives the following:
Agkistrodon
· Cantil
· Copperhead
· Cottonmouth
· Zolcuate
· Moccasin
· Cantil de agua
· Castellana
· Cmcoatl
· Metapil
· Puchucuate
· Volpoch
Other than "Copperhead" and "Cottonmouth", I'm fairly sure ALL of these are local names for the Cantil (possibly different subspecies). One is spelled wrong and two appear nowhere on the web except in copies of this list.
The point is, don't be too impressed or make purchase decisions based on the length of this list without looking up the individual names first...
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RE: RE Antivipmyn
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by Rabies on July 17, 2005
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Thanks for the papers, but not having much luck in getting them. Any body have a copy by any chance? Thanks
John
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RE: RE Antivipmyn
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by Phobos on July 17, 2005
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John:
Yes, I actually have a reprint, email me your mailing address & I'll send my extra copy by post.
Best,
Al
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RE: RE Antivipmyn
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by newherp on August 11, 2005
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With respect to the "rebound" that you refer to. Are you speaking of recurrence? There are three types of recurrence that can occur: local effects, systemic, effects, and coagulopathic effects. Once "control" is achieved it is uncommon for recurrence of the local effects to occur, and when they do they generally happpen within 24 hours of the bite. To my knowledge, recurrence of systemic effects has not been described with the use of FabAV. Now, as far as coagulopathic recurrence goes, it does happen with CroFab, as it did with Wyeth, and will likely do the same with Fab2. There have likely been many cases of patients with coagulopathies over the years who had no hemorrhage. The data being collected now seems to show that patients exhibiting a coagulapathic recurrence post discharge also had an abnormality while in the hospital. Is more antivenom warranted if an abnormality is detected? Maybe. With the consumptive effect that venom has, values may be boosted somewhat only to fall again. Clinicians seem firmly divided over the issue. Some do give an additional vial or two of antivenom if there is extreme deviation from normal or there are signs of bleeding. Most believe however that monitoring the patient with precautions against behavior that might exacerbate any effects.
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RE: RE Antivipmyn
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by Buzztail1 on May 18, 2009
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Not really answering any questions here but I thought this link was germaine to the thread and has some very interesting information.
http://clinicaltrials.gov/ct2/show/NCT00636116
R/
Karl
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