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Anti-Venom question
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by Kingetula on August 12, 2011
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Anti-Venom has a shelf life of about 2 to 3 years. Can anyone tell me who works or has worked with Venomous reptiles at a facility the amount of anti-venom a facility (Zoo for example) might throw away because it was never used and what that dollar amount might be?
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RE: Anti-Venom question
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by JoeCrotalid on August 12, 2011
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Scott:
Speaking from the Medical/Pharmaceutical aspect, the concept of shelf lives is not absolute and is based on the theory that after a certain time frame, medications (in this case, antivenin)loses a percentage of its effectiveness which has never truly been studied in detail. In my experience of treating envenomations, I have administered "expired" antivenin provided by a zoo on a couple of occasions with good results.
A current antivenin situation that reflects this is the Wyeth North American Coral Snake (Micrurus fulvius) antivenin which is now on its 3rd expiration extension.
Generally the only time there is a concern is when there is a packaging issue such as the rubber stopper on the vial being degraded or when you resconstitute the antivenin and the powder doesn't completely liquify. You may be required to use more antivenin based on that percentage of effectiveness being lost, but even expired antivenin is better than no antivenin.
Based on this, I would suspect that many zoos keep antivenins beyond their self life especially since replacement is costly and many zoo budgets are limited. Perhaps John Z or Rob Carmichael will also hit this thread with a zoo perspective.
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RE: Anti-Venom question
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by snakeguy101 on August 12, 2011
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The Santa Fe zoo here has AV that is well past 3 years expired and only a few vials- certainly not enough to fully treat a bad envenomation.
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RE: Anti-Venom question
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by theemojohnm on August 12, 2011
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I keep, included in my bite protocols, a pre-made waiver, stating that I allow the acting physician to administer antivenin to me, that may be past it's expiration date. I believe that all venomous keepers should have something similar.
Doctors may refrain from this, to cover themselves from malpractice suits. But, if I had taken a serious bite, and the only available antivenin was a year past it's suggested expiration date, I would rather be given it, than nothing.
I will have to find the article, but I have come across a study recently, that evaluated the efficiency of several common medications (mostly over-the-counter medications) past the suggested expiration dates. The study concluded that most of the medications were just as effective, even at over ten times longer shelf-life, than their recommended expiration dates!
Now, I think that this is highly dependent on the compound in question, as certain compounds degrade when exposed to light for extended periods of time, and temperature and humidity also plays a role. Also, some compounds, like some antibiotics, are known to degrade fairly rapidly, and have relatively short shelf-lives.
I think the major concern with antivenin, being derived from organic proteins, is usual organic decomposition, thus requiring the need for cold storage. Still, if kept properly, I would certainly give expired AV a go, over nothing at all.
I think that the FDA assigns 'safe' expiration dates, as with some of the new drugs being developed, we really don't have any long term data on the molecular stability of the compound(s), over time. I think that it's more them 'playing it safe', than anything. And, I would expect that most drugs approved for human use, are stable enough molecularly, to greatly exceed their printed shelf-lives, in many cases.
As far as how much AV is disposed of, I couldn’t tell you. Although I know that a lot of the zoos are probably mandated to keep ‘fresh’ stock, and probably throw out a lot more “expired” Av than I would!
Take Care,
-John Mendrola
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RE: Anti-Venom question
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by agkistrodude on August 13, 2011
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I read a similar or maybe the same article about meds having no change, 10 and 15 times the expiration date.
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RE: Anti-Venom question
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by Phobos on August 13, 2011
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There is a published journal paper by Dr. Julian White MD and others, testing vials of out dated A/V. They found even if they were outdated and even NOT stored correctly, they retain most of their effectiveness. Better than nothing in an emergency.
Al
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RE: Anti-Venom question
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by Kingetula on August 13, 2011
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Thank you for all your replies. I am curious about what John pointed out, "Although I know that a lot of the zoos are probably mandated to keep ‘fresh’ stock, and probably throw out a lot more “expired” Av than I would!".
This runs right along with my question. DO zoo's "throw out" AV if they are mandated? How much is wasted? Anyone from a Zoo know for sure?
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RE: Anti-Venom question
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by theemojohnm on August 13, 2011
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Thanks Al ! I do remember reading that article, although I seemed to remember that the basis of the study, was to determine what effects the conditions of storage had on the serum, rather than the overall shelf life.. ?
Do you know of a published source, online, for that paper..? Perhaps a PDF. I've been looking for a PDF copy, with no luck..
Scott, I will say that I don't have experience working in a public zoo setting, and I know that others here would know much more about this topic than me.
I would assume that private zoos could keep (and use) AV as long as they wanted to, at the discretion of the director and bite victim(s). Although, I would think that the AZA accredited zoos probably have more strict protocols to adhere to, regarding FDA recommendations, and expiration dates.
I know that AZA accredited facilities have fairly specific protocols to adhere to, regarding venomous collections, and require some features be in place, like alarms to alert local EMS of bites, and other stuff of that nature, that is mandated. Not sure how the private zoos fall into that, but I'd assume that it would be at their discretion.
Although, again, I'm positive that others here would know far more about the subject than me, and I’m not entirely sure.
Take Care,
-John Mendrola
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