Echis Carinatus - Venom

Venom

This species produces on the average of about 18 mg of dry venom by weight, with a recorded maximum of 72 mg. It may inject as much as 12 mg, whereas the lethal dose for an adult is estimated to be only 5 mg. Envenomation results in local symptoms as well as severe systemic symptoms that may prove fatal. Local symptoms include swelling and pain, which appear within minutes of a bite. In very bad cases the swelling may extend up the entire affected limb within 12-24 hours and blisters form on the skin. The venom yield from individual specimens varies considerably, as does the quantity injected per bite. The mortality rate from their bites is about 20%, and due to the availability of the anti-venom, deaths are much rare presently.

Of the more dangerous systemic symptoms, hemorrhage and coagulation defects are the most striking. Hematemesis, melena, hemoptysis, hematuria and epistaxis also occur and may lead to hypovolemic shock. Almost all patients develop oliguria or anuria within a few hours to as late as 6 days post bite. In some cases, kidney dialysis is necessary due to acute renal failure (ARF), but this is not often caused by hypotension. It is more often the result of intravascular hemolysis, which occurs in about half of all cases. In other cases, ARF is often caused by disseminated intravascular coagulation.

In any case, antivenin therapy and intravenous hydration within hours of the bite are vital for survival. At least eight different polyvalent and monovalent antivenins are available against bites from this species.

The venom from this species is used in the manufacture of several drugs. One is called echistatin, which is an anticoagulant. Even though many other snake venoms contain similar toxins, echistatin is not only especially potent, but also simplistic in structure, which makes it easier to replicate. Indeed, it is obtained not only through the purification of whole venom, but also as a product of chemical synthesis. Another drug made from E. carinatus venom is called ecarin and is the primary reagent in the ecarin clotting time (ECT) test, which is used to monitor anticoagulation during treatment with hirudin. Yet another drug produced from E. carinatus venom is Aggrastat (Tirofiban).