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Pharmacokinetics of Snake Venom

Clinical Toxicology Research Group, University of Newcastle, Newcastle 2298, Australia
School of Pharmacy, University of Otago, Dunedin 9016, New Zealand
Author to whom correspondence should be addressed.
Toxins 2018, 10(2), 73;
Received: 9 December 2017 / Revised: 31 January 2018 / Accepted: 3 February 2018 / Published: 7 February 2018
(This article belongs to the Section Animal Venoms)
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Understanding snake venom pharmacokinetics is essential for developing risk assessment strategies and determining the optimal dose and timing of antivenom required to bind all venom in snakebite patients. This review aims to explore the current knowledge of snake venom pharmacokinetics in animals and humans. Literature searches were conducted using EMBASE (1974–present) and Medline (1946–present). For animals, 12 out of 520 initially identified studies met the inclusion criteria. In general, the disposition of snake venom was described by a two-compartment model consisting of a rapid distribution phase and a slow elimination phase, with half-lives of 5 to 48 min and 0.8 to 28 h, respectively, following rapid intravenous injection of the venoms or toxins. When the venoms or toxins were administered intramuscularly or subcutaneously, an initial absorption phase and slow elimination phase were observed. The bioavailability of venoms or toxins ranged from 4 to 81.5% following intramuscular administration and 60% following subcutaneous administration. The volume of distribution and the clearance varied between snake species. For humans, 24 out of 666 initially identified publications contained sufficient information and timed venom concentrations in the absence of antivenom therapy for data extraction. The data were extracted and modelled in NONMEM. A one-compartment model provided the best fit, with an elimination half-life of 9.71 ± 1.29 h. It is intended that the quantitative information provided in this review will provide a useful basis for future studies that address the pharmacokinetics of snakebite in humans. View Full-Text
Keywords: snakes; venom; pharmacokinetics; elapid; viper; toxins snakes; venom; pharmacokinetics; elapid; viper; toxins

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Sanhajariya, S.; Duffull, S.B.; Isbister, G.K. Pharmacokinetics of Snake Venom. Toxins 2018, 10, 73.

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