Copperhead and Cottonmouth Envenomation Medication

Updated: Apr 10, 2019
  • Author: Sean P Bush, MD, FACEP; Chief Editor: Joe Alcock, MD, MS  more...
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Medication Summary

The physician must be prepared to support the patient's cardiovascular and respiratory systems after any venomous snakebite.





CroFab (Crotalidae Polyvalent Immune Fab Ovine)

This appears to be more specific against moccasin venom and less allergenic than Antivenin (Crotalidae) Polyvalent. It is FDA approved for moccasin envenomation.

Crotalidae immune FAB (equine) (Anavip)

Crotalidae immune FAB (equine) contains venom-specific F(ab’)2; fragments of immunoglobulin G (IgG) that bind and neutralize venom toxins, thereby facilitating redistribution away from target tissues and elimination from the body. It is used off-label in copperhead and cottonmouth envenomation.



Class Summary

These agents immunize patients against tetanus.

Diphtheria-tetanus toxoid (dT)

Diphtheria-tetanus toxoid is used to induce active immunity against tetanus in selected patients. Tetanus and diphtheria toxoids are the immunizing agents of choice for most adults and children older than 7 years. Booster doses are necessary to maintain tetanus immunity throughout life because tetanus spores are ubiquitous.

Pregnant patients should receive only tetanus toxoid, not a diphtheria antigen–containing product. In children and adults, immunization may be administered into the deltoid or midlateral thigh muscles. In infants, the preferred site of administration is the mid thigh laterally.