Comparación de la eficacia, la seguridad y la farmacocinética de los antivenenos antiofídicos: revisión de literatura

Introduction: In Colombia, around 5000 cases of snakebites are reported annually, producing a clinical poisoning whose neutralization depends on heterologous immunoglobulins. Commercially, second-generation complete immunoglobulins and third-generation fabotherapies can be found; however, their differences are unknown to many physicians. Objective: To present the main pharmacokinetic characteristics by comparing the different generations of antivenoms, as well as the frequency of side effects. Materials and Methods: A literature search was conducted in databases using a combination of descriptors and Mesh terms, in English and Spanish. Pharmacokinetic parameters were compared in preclinical studies and side effects in clinical studies. Results: From the researchers analyzed, we found that the main pharmacokinetic differences are a consequence of the size of the immunoglobulin fraction, so the fabotherapic have a greater distribution to the tissues and a shorter half-life, compared with the complete immunoglobulins. At a clinical level, studies were found that showed higher to lower presentation of side effects to complete immunoglobulins, followed by antivenoms F(ab´)2 and Fab respectively. Conclusion: There are big pharmacological differences between the generations of antivenoms, which are exposed in this document as a practical tool to optimize the adequate pharmacological treatment in snakebite.