Novel role of antiplatelet agents (aspirin plus clopidogrel) in an incoagulable blood of a victim of russell's viper snakebite

Abstract

Snake antivenom is a specific antidote to the venom action, neutralizing the circulating venom. However, it fails to neutralize the venom fixed to target organs such as platelets, renal tubules, etc. Russell's viper venom initiates rapid coagulation in a victim by activating blood platelets, factors V, X, and anticoagulant cofactors. Activation of thrombin, resulting in formation of micro-thrombi, fibrinolysis, and a vicious cascade, sets in. Inhibition of activated platelets by aspirin (cyclooxygenase inhibitor) and clopidogrel (ADP receptor inhibitor) helps to break this vicious circle induced by Russell's venom and may initiate the natural physiological clotting mechanism. They can be utilized as an adjuvant treatment.

Keywords

• Russell's viper
• coagulation
• fibrinolysis
• aspirin
• clopidogrel