Figure 1.

Most relevant toxic activities induced by venoms of different snake groups that need to be considered in the preclinical evaluation of antivenoms. Venoms of many elapid species, and few viperids, mainly induce neurotoxicity, which is assessed by lethality. Sea snake venoms induce both neurotoxicity and systemic myotoxicity. The main effect in envenomings by spitting cobras is cutaneous necrosis, which has to be evaluated in addition to lethality. Several Australian terrestrial elapids, as well as few rattlesnake venoms, induce neurotoxicity, myotoxicity and consumption coagulopathy, which depends on their coagulant enzymes. Envenomings by many viperid species cause, in addition to lethality, local tissue damage (hemorrhage and myotoxicity), and systemic effects associated with bleeding and coagulopathy. Other pathophysiological alterations that would need to be considered in the preclinical evaluation of antivenoms are thrombocytopenia, platelet hypoaggregation, acute kidney injury, and systemic vascular capillary leakage syndrome. Reproduced from [46], copyright 2013 Elsevier.