DTP Box Jellyfish Antivenom Flashcards

1
Q

Pharmacology of Box jellyfish antivenom

A

concentrated immunoglobulin acts to neutralise the toxins in the venom

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2
Q

Metabolism of Box jellyfish antivenom

A

In muscle tissue and the liver.

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3
Q

Indications for Box jellyfish antivenom

A

Box jellyfish envenomation associated with any of the following:
– a patient currently in cardiac arrest
– ALOC
– cardiac AND/OR respiratory distress
or collapse
– total surface area affected greater than half
the surface area of one limb
– intractable pain unrelieved by icepacks,
methoxyflurane AND/OR narcotic analgesia.

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4
Q

Contraindications for Box jellyfish antivenom

A

KSAR

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5
Q

Precautions for Box jellyfish antivenom

A

It is a foreign protein, which can cause sensitisation, allergic reaction or anaphylaxis

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6
Q

Side effects for Box jellyfish antivenom

A

• Allergic reaction including anaphylaxis
and delayed serum sickness
• Intense stinging sensation on injection

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7
Q

Presentation

A

Ampoule, 20,000 units/1.5 – 4 mL box jellyfish antivenom

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8
Q

Onset (IV) Duration (IV) Half-life (elimination)

A

Not available

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9
Q

Schedule

A

S4 (Restricted drugs).

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10
Q

Adult dose for box jellyfish envenomation

A

IM 60,000 units
Single dose only.

IV 20,000 units
Slow push over 10 minutes.
Single dose only.

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11
Q

What is the Syringe preparation

A

Mix 20,000 units of antivenom with sodium chloride 0.9% to achieve a final concentration of 20,000
units/20 mL.

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12
Q

Adult dose for Box jellyfish envenomation with patient in cardiac arrest

A

20,000 units
Slow push over 2–5 minutes.
Repeated immediately up to 2 times.
Total maximum dose 60,000 units.

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13
Q

Paediatric dose for Box Jellyfish envenomation

A

IM 60,000 units
Single dose only.

IV 20,000 units
Slow push over 10 minutes.
Single dose only.

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14
Q

Paediatric dose for Box jellyfish envenomation with patient in cardiac arrest

A

IV 20,000 units
Slow push over 2–5 minutes.
Repeated immediately up to 2 times.
Total maximum dose 60,000 units.

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15
Q

Speical notes

A
  • The dose of antivenom is related to the dose of venom, not based on the size of the patient.
  • IV injection is the preferred route of administration for all indications.
  • 60,000 units of antivenom may equate to a volume of up to 12 mL.
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16
Q

Administration during cardiac arrest

A

• If a patient is in cardiac arrest due to box jellyfish
envenomation, box jellyfish antivenom is only to be
administered following the commencement of effective CPR, advanced life support measures and administration of cardioactive drugs.

17
Q

IM administration

A

For the purpose of IM administration, officers may administer up to 2 mL in each Deltoid muscle and up to 5 mL in each Vastus Lateralis muscle.

18
Q

Anaphylaxis after administration

A

• At all times during antivenom therapy adrenaline must be available in case of an anaphylactic reaction.
- If reaction occurs, immediately cease the administration of box jellyfish antivenom and treat patient in accordance with the QAS Anaphylaxis and allergy CPG.