ºÝºÝߣ

ºÝºÝߣShare a Scribd company logo

Viper Bite An Overview

?Download as PPT, PDF?
?
Rashmi Mishal
Rashmi Mishal

Russell's viper is found throughout India up to 3000m in elevation. Its venom contains phospholipase A2 and other enzymes that induce severe coagulation abnormalities in humans by activating blood clotting factors. This leads to disseminated intravascular coagulation, where excessive blood clotting and bleeding occurs simultaneously. The venom's procoagulant activity is due to peptide components that activate factors IX, X, and V, as well as platelets. Russell's viper venom factor X is a major lethal toxin that affects coagulation and renal function. Together with cytotoxins, it is responsible for various toxic effects throughout the body.

1 of 8
Download to read offline
VIPER Bite- An Overview Compiled ByCompiled By R. H. MishalR. H. Mishal Asst. ProfessorAsst. Professor Sir. Dr. M. S. Gosavi College ofSir. Dr. M. S. Gosavi College of Pharmaceutical Education &Pharmaceutical Education & Research, Nashik.Research, Nashik.
¸é±«³§³§·¡³¢³¢¡¯³§³Õ±õ±Ê·¡¸é
Distribution of vipers and Pathogenesis of Russell¡¯s viperDistribution of vipers and Pathogenesis of Russell¡¯s viper ((Vipera russelliiVipera russellii) Envenomation) Envenomation ? Indian Russell¡¯s viper (Indian Russell¡¯s viper (Daboia or Vipera russelliDaboia or Vipera russelli) specifically known as) specifically known as ¡°Ghonus¡± is found thought the country up to sea level 3000m.¡°Ghonus¡± is found thought the country up to sea level 3000m. ? Russell¡¯s viper is varied in colour ranging from brown to yellowish brown.Russell¡¯s viper is varied in colour ranging from brown to yellowish brown. The underside is usually white in western or partly speckled in southeasternThe underside is usually white in western or partly speckled in southeastern & heavily speckled in northeastern races. The chain like marking of the& heavily speckled in northeastern races. The chain like marking of the classic design shows dark round spots edged with white & black.classic design shows dark round spots edged with white & black. ? Russell¡¯s viper venom is the rich source of different enzymes includingRussell¡¯s viper venom is the rich source of different enzymes including Phospholipase A2, ATPase, Hyaluronidase, & certain other componentsPhospholipase A2, ATPase, Hyaluronidase, & certain other components which act on the different parts of the human blood & induce severewhich act on the different parts of the human blood & induce severe haemostatic disturbances in the human beings.haemostatic disturbances in the human beings. ? This procoagulant activity of the Russell¡¯s viper venom is because of theThis procoagulant activity of the Russell¡¯s viper venom is because of the presence of specific peptide components of the venom which activatepresence of specific peptide components of the venom which activate different clotting factors in the blood including factor IX (Christmas factor),different clotting factors in the blood including factor IX (Christmas factor), factor X (Stuart Prower factor) factor V as well as platelets.factor X (Stuart Prower factor) factor V as well as platelets. ? This activation of many factors simultaneously produces a veryThis activation of many factors simultaneously produces a very contradictory effect in the systemic circulation of the humans, enhancingcontradictory effect in the systemic circulation of the humans, enhancing blood clotting as well as severe haemorrhage, bleeding and haemolysisblood clotting as well as severe haemorrhage, bleeding and haemolysis called ascalled as Disseminated Intravascular CoagulationDisseminated Intravascular Coagulation (( DICDIC ) of the blood.) of the blood.
Understanding the structure and function of Russell¡¯sUnderstanding the structure and function of Russell¡¯s viper venomviper venom Lethality of Russell¡¯s viper venom is attributed to the presence of several toxins andLethality of Russell¡¯s viper venom is attributed to the presence of several toxins and enzymes like phospholipase A2 (PLA2), Russell¡¯s viper venom factor X activatorenzymes like phospholipase A2 (PLA2), Russell¡¯s viper venom factor X activator (RVV-X), Russell¡¯s viper venom factor V (RVV-V), proteinases, and certain(RVV-X), Russell¡¯s viper venom factor V (RVV-V), proteinases, and certain unidentified proteins.unidentified proteins. Changes in the hemodynamics of the patients bitten by Russell¡¯s viper are suggestedChanges in the hemodynamics of the patients bitten by Russell¡¯s viper are suggested to be due to presence of proteolytic enzymes in the venom.to be due to presence of proteolytic enzymes in the venom. (i)(i) RVV-XRVV-X:: It is mainly known for its procoagulant activity. RVV-X is the majorIt is mainly known for its procoagulant activity. RVV-X is the major lethal factor in Russell¡¯s viper venom which also affects the renal haemodynamics &lethal factor in Russell¡¯s viper venom which also affects the renal haemodynamics & renal functions apart from coagulation cascade.renal functions apart from coagulation cascade. (ii)(ii) Cytotoxins:Cytotoxins: Together with cytotoxicity, cytotoxins is also responsible forTogether with cytotoxicity, cytotoxins is also responsible for neurotoxicity, cardiotoxicity & myotoxicity of the snake venom.neurotoxicity, cardiotoxicity & myotoxicity of the snake venom. (iii)(iii) Phospholipase A2 (PLA2):Phospholipase A2 (PLA2): PLA2s are responsible for hypotensive & antiPLA2s are responsible for hypotensive & anti platelet effect of the venom.platelet effect of the venom. 4
Intravascular Pathway Extravascular Pathway FactorIX Proconvertin AntihaemophiliaB Factor Activated Factor IX Convertin Factor X (Stuart Prower Factor) Activated Factor X Fibrinogen Monomer Fibrin Sight of Venom Action Fibrin Clot Ca++ Ca++
Disseminated Intravascular Coagulation (DIC)Disseminated Intravascular Coagulation (DIC) Viper BiteViper Bite
Mode of Action of Russell¡¯s viper Venom ? Important elements of viper venom toxicity are the high affinity & theImportant elements of viper venom toxicity are the high affinity & the availability of the specific receptors for presynaptically toxic PLA2s.availability of the specific receptors for presynaptically toxic PLA2s. ? The basic PLA2 fromThe basic PLA2 from Vipera russelliiVipera russellii venom induces multiple toxic effectsvenom induces multiple toxic effects like neurotoxicity, myotoxicity, edema and haemorrhage.like neurotoxicity, myotoxicity, edema and haemorrhage. ? Russell¡¯s viper venom specifically causes lung haemorrhagic activity in theRussell¡¯s viper venom specifically causes lung haemorrhagic activity in the victims of the bite which is always massive in nature.victims of the bite which is always massive in nature. ? It is also reported that direct Russell¡¯s viper bite over a vein leads to theIt is also reported that direct Russell¡¯s viper bite over a vein leads to the direct intravenous envenoming causing myocardial infarction and myocardialdirect intravenous envenoming causing myocardial infarction and myocardial ischemia in the victim.ischemia in the victim. ? They also induce significant hypotension by perforation of capillary wallsThey also induce significant hypotension by perforation of capillary walls leading to the escape of whole blood into the tissues which is the mostleading to the escape of whole blood into the tissues which is the most common symptom in viperid envenomation.common symptom in viperid envenomation.
8

More Related Content

Viper Bite An Overview

  • 1. VIPER Bite- An Overview Compiled ByCompiled By R. H. MishalR. H. Mishal Asst. ProfessorAsst. Professor Sir. Dr. M. S. Gosavi College ofSir. Dr. M. S. Gosavi College of Pharmaceutical Education &Pharmaceutical Education & Research, Nashik.Research, Nashik.
  • 3. Distribution of vipers and Pathogenesis of Russell¡¯s viperDistribution of vipers and Pathogenesis of Russell¡¯s viper ((Vipera russelliiVipera russellii) Envenomation) Envenomation ? Indian Russell¡¯s viper (Indian Russell¡¯s viper (Daboia or Vipera russelliDaboia or Vipera russelli) specifically known as) specifically known as ¡°Ghonus¡± is found thought the country up to sea level 3000m.¡°Ghonus¡± is found thought the country up to sea level 3000m. ? Russell¡¯s viper is varied in colour ranging from brown to yellowish brown.Russell¡¯s viper is varied in colour ranging from brown to yellowish brown. The underside is usually white in western or partly speckled in southeasternThe underside is usually white in western or partly speckled in southeastern & heavily speckled in northeastern races. The chain like marking of the& heavily speckled in northeastern races. The chain like marking of the classic design shows dark round spots edged with white & black.classic design shows dark round spots edged with white & black. ? Russell¡¯s viper venom is the rich source of different enzymes includingRussell¡¯s viper venom is the rich source of different enzymes including Phospholipase A2, ATPase, Hyaluronidase, & certain other componentsPhospholipase A2, ATPase, Hyaluronidase, & certain other components which act on the different parts of the human blood & induce severewhich act on the different parts of the human blood & induce severe haemostatic disturbances in the human beings.haemostatic disturbances in the human beings. ? This procoagulant activity of the Russell¡¯s viper venom is because of theThis procoagulant activity of the Russell¡¯s viper venom is because of the presence of specific peptide components of the venom which activatepresence of specific peptide components of the venom which activate different clotting factors in the blood including factor IX (Christmas factor),different clotting factors in the blood including factor IX (Christmas factor), factor X (Stuart Prower factor) factor V as well as platelets.factor X (Stuart Prower factor) factor V as well as platelets. ? This activation of many factors simultaneously produces a veryThis activation of many factors simultaneously produces a very contradictory effect in the systemic circulation of the humans, enhancingcontradictory effect in the systemic circulation of the humans, enhancing blood clotting as well as severe haemorrhage, bleeding and haemolysisblood clotting as well as severe haemorrhage, bleeding and haemolysis called ascalled as Disseminated Intravascular CoagulationDisseminated Intravascular Coagulation (( DICDIC ) of the blood.) of the blood.
  • 4. Understanding the structure and function of Russell¡¯sUnderstanding the structure and function of Russell¡¯s viper venomviper venom Lethality of Russell¡¯s viper venom is attributed to the presence of several toxins andLethality of Russell¡¯s viper venom is attributed to the presence of several toxins and enzymes like phospholipase A2 (PLA2), Russell¡¯s viper venom factor X activatorenzymes like phospholipase A2 (PLA2), Russell¡¯s viper venom factor X activator (RVV-X), Russell¡¯s viper venom factor V (RVV-V), proteinases, and certain(RVV-X), Russell¡¯s viper venom factor V (RVV-V), proteinases, and certain unidentified proteins.unidentified proteins. Changes in the hemodynamics of the patients bitten by Russell¡¯s viper are suggestedChanges in the hemodynamics of the patients bitten by Russell¡¯s viper are suggested to be due to presence of proteolytic enzymes in the venom.to be due to presence of proteolytic enzymes in the venom. (i)(i) RVV-XRVV-X:: It is mainly known for its procoagulant activity. RVV-X is the majorIt is mainly known for its procoagulant activity. RVV-X is the major lethal factor in Russell¡¯s viper venom which also affects the renal haemodynamics &lethal factor in Russell¡¯s viper venom which also affects the renal haemodynamics & renal functions apart from coagulation cascade.renal functions apart from coagulation cascade. (ii)(ii) Cytotoxins:Cytotoxins: Together with cytotoxicity, cytotoxins is also responsible forTogether with cytotoxicity, cytotoxins is also responsible for neurotoxicity, cardiotoxicity & myotoxicity of the snake venom.neurotoxicity, cardiotoxicity & myotoxicity of the snake venom. (iii)(iii) Phospholipase A2 (PLA2):Phospholipase A2 (PLA2): PLA2s are responsible for hypotensive & antiPLA2s are responsible for hypotensive & anti platelet effect of the venom.platelet effect of the venom. 4
  • 5. Intravascular Pathway Extravascular Pathway FactorIX Proconvertin AntihaemophiliaB Factor Activated Factor IX Convertin Factor X (Stuart Prower Factor) Activated Factor X Fibrinogen Monomer Fibrin Sight of Venom Action Fibrin Clot Ca++ Ca++
  • 6. Disseminated Intravascular Coagulation (DIC)Disseminated Intravascular Coagulation (DIC) Viper BiteViper Bite
  • 7. Mode of Action of Russell¡¯s viper Venom ? Important elements of viper venom toxicity are the high affinity & theImportant elements of viper venom toxicity are the high affinity & the availability of the specific receptors for presynaptically toxic PLA2s.availability of the specific receptors for presynaptically toxic PLA2s. ? The basic PLA2 fromThe basic PLA2 from Vipera russelliiVipera russellii venom induces multiple toxic effectsvenom induces multiple toxic effects like neurotoxicity, myotoxicity, edema and haemorrhage.like neurotoxicity, myotoxicity, edema and haemorrhage. ? Russell¡¯s viper venom specifically causes lung haemorrhagic activity in theRussell¡¯s viper venom specifically causes lung haemorrhagic activity in the victims of the bite which is always massive in nature.victims of the bite which is always massive in nature. ? It is also reported that direct Russell¡¯s viper bite over a vein leads to theIt is also reported that direct Russell¡¯s viper bite over a vein leads to the direct intravenous envenoming causing myocardial infarction and myocardialdirect intravenous envenoming causing myocardial infarction and myocardial ischemia in the victim.ischemia in the victim. ? They also induce significant hypotension by perforation of capillary wallsThey also induce significant hypotension by perforation of capillary walls leading to the escape of whole blood into the tissues which is the mostleading to the escape of whole blood into the tissues which is the most common symptom in viperid envenomation.common symptom in viperid envenomation.
  • 8. 8