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NEUROTOXIC POLYVALENT ANTIVENIN (COBRA, KING COBRA, BANDED KRAIT AND MALAYAN KRAIT ANTIVENIN)

Thai name เซรุ่มแก้พิษงูระบบประสาทชนิดรวม (SERUM KAE PHIT NGU RABOP PRASAT CHANID RUAM)

Category Passive immunizing agent.

          Neurotoxic Polyvalent Antivenin is a sterile preparation containing the specific antitoxic globulins from immunized animals. It has the power of neutralizing the cobra (Naja kaouthia) venom, the king cobra (Ophiophagus hannah) venom, the banded krait (Bungarus fasciatus) venom, and the Malayan krait (Bungarus candidus) venom.

          The antivenin, reconstituted if necessary as stated on the label, complies with the requirements stated under Antisera, with the following modifications.

Description Colourless or slightly yellowish brown transparent liquid. Freeze-dried antivenin consists of solid exhibiting the characteristic structure of a freezedried solid, light cream in colour.

Expiration date; Warning See under Cobra Antivenin, p. 232.

Labelling Complies with the “General Information for Antisera”, p. 225. In addition the label on the container states (1) the number in mg of reference cobra venom, reference banded krait venom, reference king cobra venom, and reference Malayan krait venom, neutralized by a specified quantity of the antivenin; (2) the recommended human dose; (3) the nature of the preparation, e.g. natural serum or purified immunoglobulin or treated immunoglobulin and, if purified or treated, the nature of the process.

Identification Specifically neutralizes the cobra venom, the banded krait venom, the king cobra venom, and the Malayan krait venom, rendering it harmless to susceptible animals. The assay may serve as an identification test.

Assay Each ml contains sufficient antitoxic globulins to neutralize the amount of the cobra venom, the banded krait venom, the king cobra venom, and Malayan krait venom stated on the label when determined by the “Biological Assay of Cobra Antivenin” (Appendix 15.2.7); use the cobra test venom, the banded krait test venom, the king cobra test venom, and the Malayan krait test venom, for determining its capacity to neutralize the lethal effect.

Usual dose Initial dose 20 ml of liquid or freeze-dried Neurotoxic Polyvalent Antivenin (after reconstitution by accompanying diluent) should be given by slow intravenous infusion (not more than 1 ml per minute). If symptoms still persist, the second dose should be repeated 2 hours or even earlier after the initial dose. The further dose should be repeated every 6 hours according to the clinical symptoms.

MONOGRAPHS • NEUROTOXIC POLYVALENT ANTIVENIN (COBRA, KING COBRA, BANDED KRAIT AND MALAYAN KRAIT ANTIVENIN)
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หมายเหตุ / Note : TP II 2011 PAGE 236