Bothrops atrox
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Family: Viperidae
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Subfamily: Crotalinae
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Genus: Bothrops
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Species: atrox
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Common Names
Common Lancehead , Barba Amarilla , Mapanare , Caissaca , Fer-de-lance
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Local Names
Acuamboia , Ala , Aroani , Bergimaka , Bula , Cacutali , Caicaca , Caissaca , Cambeua , Cascabel , Comboia , Cuaima Parda , Cuamboia , Equis , Cuatronarices , Guyanesa , Ihdoni , Jararaca , Jararaca do Norte , Jararaca-do-rabo-branco , Jararaca Grao de Arroz , Jergon , Jergona , Jergon de la Selva , Juba-vitu , Karahirima , Labaria , Labarri , Labarriayre , Lanspuntslang , Macanchi , Machacu , Macubuleru , Mapana , Mapanare , Mapanare Guayanesa , Mapanare de Carabobo , Mapanare Terciopelao, Mapepire Balsain , Marashar , Mata Caballo , Montanosa , Nacarita , Nashipkit , Nenenenca , Owroekoekoe , Petjake , Pialala , Pitalala , Pudridora , Putrificador , Rabo Amarillo , Rabo de Candela , Rasper , Sahru-ima , Sororaima , Taya , Taya Equis , Terciopelo , Yopperojobobo Venosa
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Region
South America
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Countries
Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Suriname, Trinidad and Tobago, Venezuela
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Taxonomy and Biology
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Adult Length: 0.80 m
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General Shape
Medium to large in length, moderately heavy bodied pitviper with a short tail. Can grow to a maximum of about 1.80 metres. Head is broad, flattened, lance shaped when viewed from above and distinct from narrow neck. Snout is not elevated. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are keeled. Dorsal scale count usually ( 21 to 27 ) - ( 23 or 25 ) - ( 19 to 21 ).
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Habitat
Rainforest, lower montane wet forest, savanna gallery forest and tropical deciduous forest. Frequently encountered in cultivated areas and human settlements ( including urban fringes ) near close proximity to rivers, streams or lakes.
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Habits
Terrestrial and mainly a nocturnal snake, spending the day hidden among roots, leaf litter or other similar locations. Fast moving snake which will defend itself vigorously if disturbed.
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Prey
Juveniles tend to feed on small vertebrates. Adults feed mainly on small mammals but will eat lizards, snakes, birds and frogs.
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Venom
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Average Venom Qty
70 to 160 mg ( dry weight ), U.S. Dept. Navy (1968) ( Ref : R000914 ).
150 to 300 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).
Para, Brazil : 120 mg ( dry weight ) ( range 64 to 176 ), Sanchez et al (1992) ( Ref : R000690 ).
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General: Venom Neurotoxins
Probably not present
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General: Venom Myotoxins
Systemic myotoxins present
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General: Venom Procoagulants
Prothrombin convertors
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General: Venom Anticoagulants
Probably not present
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General: Venom Haemorrhagins
Zinc metalloproteinase
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General: Venom Nephrotoxins
Possibly present
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General: Venom Cardiotoxins
Probably not present
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General: Venom Necrotoxins
Possibly present
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General: Venom Other
Unknown
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Clinical Effects
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General: Dangerousness
Severe envenoming likely, high lethality potential
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General: Rate of Envenoming: Unknown, but possibly >80%
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General: Untreated Lethality Rate: Unknown but may cause major envenoming
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General: Local Effects
Marked local effects; pain, severe swelling, bruising, blistering, necrosis, abscess formation
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General: Local Necrosis
Potentially may occur
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
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General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
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General: Myotoxicity
Insufficient clinical reports to know
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General: Coagulopathy & Haemorrhages
Common, moderate to severe coagulopathy + haemorrhagins causing extensive bleeding
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General: Renal Damage
No case reports for this species, but related species can cause renal failure secondary to coagulopathy.
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General: Cardiotoxicity
Does not occur, based on current clinical evidence
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General: Other
Shock secondary to fluid shifts due to local tissue injury is likely in severe cases
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First Aid
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Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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Details
1. After ensuring the patient and onlookers have moved out of range of further strikes by the snake, the bitten person should be reassured and persuaded to lie down and remain still. Many will be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically. The basis for reassurance is the fact that many venomous bites do not result in envenoming, the relatively slow progression to severe envenoming (hours following elapid bites, days following viper bites) and the effectiveness of modern medical treatment. 2. The bite wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged. 3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if oedema develops. 4. The bitten limb should be immobilised as effectively as possible using an extemporised splint or sling; if available, crepe bandaging of the splinted limb is an effective form of immobilisation. 5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention. 6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock. 7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration. 8. If the offending snake has been killed it should be brought with the patient for identification (only relevant in areas where there are more than one naturally occurring venomous snake species), but be careful to avoid touching the head, as even a dead snake can envenom. No attempt should be made to pursue the snake into the undergrowth as this will risk further bites. 9. The snakebite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back. 10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus), injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on.
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Treatment
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Treatment Summary
This treatment advice is general for most Bothrops species. Bites will vary from minor to life threatening. Therefore manage all bites as potentially major. Look for moderate to severe local effects, including pain, swelling, potential for fluid shifts and hypovolaemic shock, blistering, necrosis, abscess formation. Systemic effects may be minor or severe, possibly including coagulopathy and bleeding, kidney damage, even myolytic muscle damage. All cases with significant systemic effects require IV antivenom, as will most cases with significant local effects.
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Key Diagnostic Features
Local swelling, blistering, necrosis + coagulopathy, bleeding
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General Approach to Management
All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.
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Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
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1. Antivenom Code: SAmICP01
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Antivenom Name: Polyvalent Antivenom
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Manufacturer: Instituto Clodomiro Picado
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Phone: ++506-2511-7888
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Address: Contiguo a la plaza de deportes, Dulce Nombre de Coronado. San José Costa Rica
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Country: Costa Rica
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2. Antivenom Code: SAmIBB03
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Antivenom Name: Soro antibotropico-laquetico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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3. Antivenom Code: SAmIBB05
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Antivenom Name: Soro botropico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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4. Antivenom Code: SAmFED01
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Antivenom Name: Soro Antibotropico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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5. Antivenom Code: SAmFED02
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Antivenom Name: Soro Anti-botropico-crotalico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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6. Antivenom Code: SAmFED04
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Antivenom Name: Soro Antibotropico-laquetico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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7. Antivenom Code: SAmCBV01
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Antivenom Name: Suero Antiofidico polyvalente
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Manufacturer: Centro de Biotecnologia
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Phone: ++58-212-605-2704
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Address: Faculta de Farmacia, Universidad Central de Venezuela Av. Principal de Los Llustres Los Caguaramos Caracas,
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Country: Venezuela
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8. Antivenom Code: SAmINP01
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Antivenom Name: Suero Antibotropico Polivalente
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Manufacturer: Instituto Nacional de Salud
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Phone: ++51-1-467-4499
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Address: Centro Nacional de Produccion de Biologicos Av. Defensores del Morro 2268 Chorrillos Lima 9
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Country: Peru
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9. Antivenom Code: SAmIBB07
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Antivenom Name: Soro antibotropico-crotalico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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10. Antivenom Code: SAmIBM06
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Antivenom Name: Antivipmyn
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Manufacturer: Instituto Bioclon
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Phone: ++56-65-41-11
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Address: Calzada de Tlalpan No. 4687 Toriello Guerra C.P. 14050 Mexico, D.F.,
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Country: Mexico
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11. Antivenom Code: SAmLBP01
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Antivenom Name: Anti : Bothopicos - Lachesicos - Crotalicos
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Manufacturer: Laboratorios Biologicos PROBIOL Ltda.
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Phone: +571-6773057, +571-6711023
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Address: Sandafe de Bogota
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Country: Colombia
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12. Antivenom Code: SAmNIC02
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Antivenom Name: Antibothropic-Anticrotalic Polyvalent
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Manufacturer: Instituto Nacional de Salud
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Phone: ++571-220-7700
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Address: Av. Eldorado con Carrera, Zona G, Bogota D.E.,
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Country: Colombia
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Images
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Brazil ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Ecuador ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Venezuela ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Julian White ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Franck Principaud]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Jurg Meier ]
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