MEDICINES CONTAINING SNAKE VENOM: HISTORY OF DEVELOPMENT, NOMENCLATURE, AUTHENTICITY ASSESSMENT

Instead of traditional painkillers, which cause a lot of side effects, more and more doctors are recommending natural remedies for joint diseases.
Using joint ointment with snake venom, you can achieve quick and lasting analgesia, no worse than taking NSAIDs. Cobra venom contains a toxin that is a stronger pain reliever than morphine, without causing addiction. In addition, snake venoms do not cause undesirable effects such as gastritis and heartburn, which often accompany the use of NSAIDs. Many people are afraid to use ointment with snake venom for joints due to possible toxicity. But it should be borne in mind that when dried, toxins are partially neutralized. The preparations use a minimum dosage, and no more than 5–7% of the active ingredients penetrate the skin.

Varieties of snake venom

When choosing ointment with snake venom for joints, it is important to understand that they have different effects. Snake venoms are divided into two main types:

• Neurotoxic (venom of cobra, sea snakes, adders);
• Hemotoxic (venom of viper, viper, rattlesnakes).

Neurotoxic drugs have a curare-like effect, blocking impulse transmission at neuromuscular synapses. This occurs by blocking potassium channels and binding of toxins to the acetylcholine receptors of the synapse. The transmission of signal from nerve to muscle is blocked. Under natural conditions, when a snake bites, this causes paralysis of the skeletal muscles, immobilizing the victim. Many neurotoxic poisons also contain cardiotropic components. For example, taikatoxin inhibits the transport of calcium ions into myocardial cells, disrupting the contractile function of the heart.

Hemotoxic affect blood clotting.
They contain a large number of proteolytic enzymes, which, when bitten by a snake, destroy tissue proteins, releasing a large amount of bioactive substances, primarily histamine. Histamine increases the permeability of vascular walls, intravascular pressure decreases, and edema develops. Some enzymes in the composition (for example, serinoproteases) cause sharp blood clotting (coagulation), while others (metalloproteases), on the contrary, thin it. Also, type 2 venom has a local cytotoxic effect, causing necrosis at the site of the bite. IMPORTANT! The division of snake venoms into types is arbitrary. Cobra venom, despite the fact that it belongs to the first type, also contains hemotoxin, which thins the blood. And viper venom, which is classified as hemotoxic, also has a neurotoxic effect, but partially loses its neurotoxicity when dried.

Pharmacological effect

Ointment for joints based on type 1 (for example, cobra) when applied to the skin has several effects:

• locally irritating;
• analgesic: due to the content of orphiotoxin, which is stronger than morphine;
• antispasmodic, anticonvulsant: due to inhibition of impulse transmission along nerve fibers;
• anti-inflammatory;
• anticoagulant: thins the blood, improves microcirculation;
• vasodilator.

The pharmacological action of type 2 , including viper and viper, can be described as:

• local irritant: stimulation of sensitive receptors of the skin and subcutaneous tissue at the site of application;
• vasodilator: due to irritation of receptors in the walls of blood vessels;
• hemocoagulation: sudden blood clotting (coagulation);
• hemolytic: dissolution of red blood cells under the action of enzymes in the poison;
• absorbable: hyaluronidase and other enzymes promote the absorption of rough scar connective tissue, which accelerates the healing process and improves joint function;
• pain reliever: viper venom also blocks the transmission of nerve impulses and reduces pain.

General indications

Snake venom for joints in ointments is used for a number of diseases of the joints and surrounding tissues (muscles, tendons and ligaments). These include inflammatory processes, dystrophy, trauma, autoimmune pathology and pain syndromes of various origins .

The main ones:

• injuries: bruises, sprains, dislocations;
• arthritis, including rheumatoid;
• osteochondrosis;
• arthrosis;
• joint pain;
• gout;
• paresthesia, numbness of the back, shoulders;
• myositis (inflammation of skeletal muscles);
• bursitis, synovitis;
• myalgia (muscle pain of various etiologies);
• neuritis (inflammation of the peripheral nerve);
• neuralgia (pain along the nerve trunk);
• radiculitis (inflammation of the spinal nerve roots);
• sciatica (pain spreading along the sciatic nerve);
• lumbago (lumbago in the lower back).

What is sciatica?

From Latin, “radiculitis” is translated as “inflammation of the roots of the spinal nerves . It usually occurs against the background of pathological changes in the spine, primarily against the background of osteochondrosis.

Inflammation of the nerve root causes pain in sciatica

With osteochondrosis, the nutrition of the intervertebral disc, which is responsible for the elasticity and flexibility of the spine, is disrupted. Over time, the disc becomes thinner and finally loses fluid, i.e. its ossification occurs.

Gradually, the distance between the vertebrae decreases, the nerve roots are compressed and inflamed. This pathological process is called radiculitis.

Names and characteristics of drugs based on viper venom

Ointments for joints based on viper snake venom have a local irritant and anesthetic effect due to irritation of superficial sensitive nerve endings in the skin and underlying tissue. Their influence is accompanied by vasodilation and blood flow, thereby improving tissue trophism.

In its pharmacological effect, viper venom is similar to other locally irritating components (turpentine, camphor) in that it dilates blood vessels. Therefore, in the ointment they are contained in a complex to enhance each other’s effect. In addition, it contains hyaluronidase, which promotes the resorption of hematomas and scar tissue in the joints and improves their mobility. And the neurotoxic component has an analgesic effect.

Viprosal B

Ointment with viper venom for joints Viprosal B is a complex preparation. Contains additional turpentine, camphor and salicylic acid. The complex of locally irritating components produces a distracting effect due to burning of the skin. And salicylate has an anti-inflammatory and keratolytic effect. Vasodilation under the influence of the ointment leads to improved trophism in tissues and their rapid restoration. The advantage of the ointment is its natural composition, rapid absorption and affordable price, but some patients say the smell is too strong.

Salvisar

This ointment has an identical composition to Viprosal B with minor differences in the excipients. But if Viprosal B is produced in Latvia and Estonia, then Salvisar is a Russian drug and costs a little less.

The ointment should be applied 1-2 times a day, 5-10 g, which corresponds to 1-2 teaspoons, gently rubbing into the skin.

The duration of therapy without consulting a doctor is no more than 10 days. The appearance of burning and redness after applying the ointment is a normal local reaction that should subside within a few minutes after application. If the symptoms are too pronounced and persist for a long time, it is better to remove the ointment from the skin.

This snake venom ointment for joints is contraindicated for pregnant women and children under 6 years of age. From 6 to 18 years of age it should be used with extreme caution. In addition to standard contraindications for all local irritants, Salvisar is prohibited for use in aspirin-induced bronchial asthma.

When combined with other local drugs, it is worth considering that Salvisar ointment, due to vasodilation, can enhance their effect. When used together with methotrexate, the ointment may increase its toxicity. And when used simultaneously with hypoglycemic drugs, Salvisar reduces their effect.

Video: Salvisar ointment for leg pain

This video describes the benefits of Salvisar ointment, indications for use and its effectiveness for pain syndrome. SubTatiana about Salvisar ointment - an effective remedy for pain in muscles and joints

Mithridates of Pontus and his universal antidote

Mithridates VI Eupator of Pontus (132–63 BC) inherited the kingdom of Pontus on the Black Sea (today the northeastern region of Turkey) in 120 BC. e., after his father was poisoned by his enemies. It is believed that Mithridates' mother, Queen Laodice, intended to poison him in order to reign herself, so Mithridates went into hiding for several years as a teenager. His strong passion was poisons. He caught poisonous spiders, wasps and snakes and experimented with poisons. Fearing that he would be poisoned by his rivals, Mithridates took weak doses of arsenic daily in order to develop immunity to large doses. Upon his return, he ascended the throne and used poison to eliminate several relatives and rivals. Mithridates' interest in poisons and antidotes may have been influenced by the works of the last Pergamon king, Attalus III. Pergamon, with its large library, active scientific society, and healing temple of Asclepius, was a center of medical learning. As a child, Mithridates heard rumors that Attalus III poisoned his relatives and enemies and left court life, devoting himself to the study of botany, pharmacology and metallurgy. He died in 133 BC. e. - time close to the date of birth of Mithridates [, ]. Ancient historians report that Attalus grew toxic plants such as henbane, hellebore, hemlock and aconite. The renowned Pergamon physician Galen (129–199) wrote that Attalus experimented with antidotes for the venoms of snakes, spiders and scorpions, and praised his work.

Mithridates' homeland of Pontus was famous for its extraordinary flora and fauna. Wild honey, obtained by bees from the nectar of poisonous rhododendrons and oleanders, so abundant on the Black Sea coast, contained deadly toxins. The flesh of Pontic ducks was poisonous because they ate Caucasian hellebore and other poisonous plants. Mithridates' allies in the east, in Armenia, had lakes with poisonous fish. These facts may have prompted him to look for ways to protect himself from poisons. Mithridates, continuing his toxicological experiments, was looking for a universal antidote. His reserves included arrow poisons, snake poisons, scorpion poisons from Mesopotamia and Libya, poisonous fish from Armenia, poisonous plants and mushrooms, poisonous honey collected by bees from rhododendrons, and other deadly drugs. Mithridates' library contained scientific treatises on poisons, and he conducted extensive correspondence regarding poisons and antidotes. Pliny wrote: “Through tireless research and a variety of experiments, he sought ways to transform poisons into useful medicines” []. Mithridates kept his work on producing a universal antidote secret. It is believed that the recipe contained more than 50 ingredients, many of which were costly substances from distant lands [, ].

Mithridates, after being defeated by Pompey in the Third Mithridatic War, was forced to commit suicide (63 BC). He is recognized as the first experimental toxicologist who performed proto-scientific experiments with poisons and antidotes []. His goal was to create a universal antidote to make himself and his friends immune to all poisons and toxins[].

After Mithridates' death, his personal library and archives were transported to Rome and translated into Latin by Lenaeus (95–25 BC). Pliny, who studied the documents, believed that "Mithridates was a more accomplished researcher in biology than any man before him." Subsequently, the antidote of Mithridates - mithridatium - was improved, and so-called polyvalent antidotes were created. In the Middle Ages, mithridatium became widespread in Europe and became a “long-lived” medicine; it could be purchased back in the 20th century.

Based on cobra toxin

Ointments for joints with cobra snake venom do not include the entire venom of this snake, but only one of its toxins - cobrataxin . When applied topically to the skin, it has an analgesic effect and relieves spasms by inhibiting the transmission of pain impulses along the nerve trunks. Cobrataxin also thins the blood and dilates blood vessels, stimulating the acceleration of metabolism and trophism. Ointments with cobra snake venom are especially indicated for joint and muscle pain, neuralgia and other pain syndromes.

Cobratoxan, Hong Linh Cot, Bach Xa

The Vietnamese ointment Cobratoxan contains:

• cobra venom;
• menthol: simultaneously irritates the skin, providing a distracting effect, and cools it, compensating for the burning sensation from other components of the drug;
• methyl salicylate: a member of the group of non-steroidal analgesics, has an anti-inflammatory effect, which also helps reduce pain;
• excipients for easy application.

Since Cobratoxan ointment with snake venom for joints exerts its effect not on the surface of the skin, but at depth, it is applied in parts with breaks.

First, 1–2 g is applied to the problem area and lightly rubbed in with massage movements; after half an hour, the procedure is repeated for deeper penetration of the components..

Normally, the skin at the application site should become moderately red with a burning sensation. To enhance the effect, the area with the ointment can be covered with a warm cloth. One application per day is usually sufficient. For severe pain, twice the application is acceptable.

As with other locally irritating drugs, after applying Cobratoxan it is important to wash your hands thoroughly so as not to get it into your eyes or mucous membranes. You should not use the ointment on damaged skin. According to consumer reviews, the main advantage of the ointment is its natural composition and rapid pain relief, due to which it is actively used by athletes and for pain syndromes. In particular, ointment with cobra snake venom helps well against radiculitis and other lumbar and joint pain.

Nayatoks

In composition and effect, snake venom-based ointment for joints Nayatox is similar to Cobratoxan, but differs by the addition of camphor and eucalyptus oil instead of menthol.
In addition, Nayatox contains several times less poison and acts more gently, although not as quickly as Cobratoxan. The combination of cobra venom and eucalyptus oil stimulates the regeneration of damaged tissue. A component of eucalyptus oil, cineole, helps reduce inflammation and pain. Camphor enhances the local irritant effect and expands capillaries, stimulating blood circulation. IMPORTANT! Despite their similar composition, Cobratoxan and Nayatoks contain venoms from different types of cobras. Cobratoxan is an ointment based on the snake venom of the king cobra, and Nayatoks is based on the venom of the Naya cobra. The venom of the king cobra is better at treating pain due to arthritis, and the venom of the Naya cobra is an excellent treatment for neuralgia, because... connects specifically with nerve endings.

Instructions for use

For external use only. Apply to the affected area in small portions up to 5 grams and rub into the skin with massage movements. Depending on the intensity of the pain, rubbing once or twice a day is indicated.

Preparations with cobra venom are used for no longer than ten days; the duration of treatment with other ointments is determined by the attending physician on an individual basis.

Avoid contact with mucous membranes. After rubbing, wash your hands thoroughly. If the ointment gets on the mucous membranes of the eyes or mouth, rinse thoroughly with running water and consult a doctor.

An allergy test is recommended before use. To do this, one or two grams of ointment are applied to the wrist or elbow. The skin reaction is observed throughout the day. If there is swelling, severe tingling, rash and redness that does not go away within 5-15 minutes after use, wash off the ointment and do not use it for treatment.

Based on viper enzymes

The venom of the viper is one of the most expensive, since this snake is included in the Red Book and is more dangerous to work with than other vipers. The venom of the viper belongs to the second type (hemotoxic), it clots the blood and has a hemolytic effect (dissolves red blood cells). Due to its coagulation effect, it is used for the production of hemostatic agents.

But in addition to its effect on the blood, the venom also has a neurotoxic effect, like cobra venom. It blocks cholinergic receptors, inhibiting the transmission of impulses along the nerves. Due to this, the venom has an analgesic effect , and ointments with snake venom for joints are effective for all kinds of pain syndromes.

The rich content of enzymes in viper venom (phosphodiesterase, phospholipase A2, endopeptidase, hyaluronidase) provides local absorbable and anti-inflammatory effects , rapid healing and accelerated tissue regeneration.

Vipratox

Vipratox is the most popular name for ointment for joints with viper snake venom. The composition includes camphor, fir oil and salicylic acid. All these components have a local irritant effect, thereby reducing pain (distracting effect). There is also expansion of capillaries and blood flow with the appearance of a feeling of moderate warmth. Salicylic acid additionally exhibits an anti-inflammatory effect. And fir oil, due to its fat solubility, ensures better penetration of components into tissues.

Vipratox should be applied in portions, thoroughly rubbing 5–10 g of the drug. Frequency of application per day – once or twice, until the pain subsides .

Like other locally irritating agents, Vipratox ointment can only be applied to entire skin, and after application you should wash your hands so that particles of the drug do not get on other parts of the body and mucous membranes. To avoid allergic reactions, the first time Vipratox, a snake venom-based ointment for joints, is applied in a small amount and on a small area of ​​skin.

Doctors' advice

“Patients often ask about ointments with snake venom, but such a drug must be selected on an individual basis. Ideally, try all available drugs on the skin and choose the one whose active composition has the greatest effect. In other cases, I try to prescribe domestically produced ointments to make it easier for the patient to find the drug in pharmacies.”

Vitaly Ivanovich, rheumatologist, Saratov

“I have never denied the effectiveness of ointments with snake venom, but I urge that these are means for symptomatic treatment. They do not eliminate the causes of pain, but only mask it in order to improve the patient’s quality of life. Complex therapy is mandatory.”

Igor Yurievich, vertebrologist, Moscow

Combination medications

There are ointments containing toxins from several snakes at once. They have a more pronounced and varied effect. Although allergic reactions to such drugs are detected more often.

Kapkotoks

The Vietnamese cream Kapkotoks contains the venoms of three snakes at once: the king cobra, the green boiga and the white-lipped keffiyeh. It is characterized by an almost instantaneous and strongly pronounced analgesic effect. In addition, this ointment for joints contains methyl salicylate, which has an anti-inflammatory effect, and menthol, which irritates and at the same time cools the skin.

You need to apply the ointment up to 3 times a day, rubbing it in with massaging movements. Course of treatment – ​​7–10 days .

Its use is contraindicated for children, pregnant and lactating women. Avoid application to damaged skin, mucous membranes and accidental contact with the eyes. The advantages of the drug are fast and strong pain relief, good absorption and an affordable price.

Possible adverse reactions

Undesirable effects from snake venom ointments for joints, the names of which are listed above, boil down to allergic reactions. Their main symptoms:

• skin rash similar to urticaria;
• itching;
• swelling of the skin;
• redness.

To avoid such signs, it is worth performing a hypersensitivity test . To do this, the ointment should be applied in small quantities and to a small area of ​​skin (on the wrist). Normally, moderate burning and redness should appear. If there is excessive burning or a rash, you should not use the ointment.

General contraindications

The use of joint ointment with snake venom is contraindicated for:

• hypersensitivity to any of the components;
• contact dermatitis and infectious skin lesions;
• ulcerative lesions and skin injuries;
• tendency to seizures;
• fever;
• tuberculosis;
• severe liver and kidney failure;
• peptic ulcers of the gastrointestinal tract (stomach, duodenum, colon);
• severe liver and kidney failure;
• tendency to bronchospasm;
• whooping cough;
• bronchial asthma;
• disturbances of cerebral circulation and spasms of cerebral vessels;
• pregnancy and lactation;
• children under 12 years of age;
• severe exhaustion of the body.

Remember:

1. There are two main types of snake venom: neurotoxic and hemotoxic. The first type has a predominantly anesthetic effect and has a distant effect. The second type is characterized by irritating, anti-inflammatory and absorbable effects, producing a local effect.
2. A neurotoxic poison thins the blood, and a hemotoxic poison clots it. The first type includes cobra venom; it is included in such ointments for joints as Nayatox, Cobratoxan, Kapkotoks. The second type includes venoms of vipers, including vipers. They are included in such ointments for joints as Viprosal B, Salvisar, Alvipsal.
3. Often, such ointments also contain other components: turpentine, which increases local irritation, and salicylic acid, which also has an anti-inflammatory effect.
4. Ointments with snake toxins are used both for joint injuries and for chronic rheumatic diseases, arthrosis, arthritis, and pain syndromes.
5. Due to their strong irritating effect, their application to damaged skin and mucous membranes, as well as application if you are allergic to one of the components, is contraindicated.
6. Although snake venom-based joint ointments are considered safe, side effects such as contact dermatitis or allergic reactions are possible. Therefore, before starting use, it is recommended to test them on a small area of ​​skin.

What types of medications are used for sciatica?

Patients with radiculitis may be prescribed medications in different dosage forms.

Pills

Treatment of radiculitis is carried out using the following drugs in the form of tablets : anti-inflammatory drugs, analgesics, diuretics, drugs to influence the etiology of radiculitis (antibiotics, antiviral drugs, steroids), neurovitamins, muscle relaxants, antihypoxants, neurotransmitters, chondroprotectors.

If treatment with tablets is ineffective, patients are prescribed injectable forms of drugs.

Injections

Intramuscular or intravenous injections are practiced in the presence of severe pain syndrome.

Very often, for radiculitis, medications are used in the form of injections. Injections relieve muscle spasms and help quickly eliminate painful sensations. Most often, local anesthetics such as Novocaine, Trimecaine and Lidocaine are used for radiculitis.

They should be administered by an experienced doctor. Otherwise, the substance may enter the vascular bed and cause a sharp decrease in blood pressure.

In the form of injections for radiculitis, they can be administered:

• non-steroidal anti-inflammatory drugs;
• biologically active substances that improve blood circulation in the area of ​​inflammation;
• vitamin complexes that restore metabolism in damaged nerve fibers;
• adhesiolysis is the introduction into the epidural space of the spine of complex solutions containing local anesthetics, steroid hormones, and B vitamins.

Blockades

Sometimes sciatica requires a quick response. In this case, novocaine blockades are used.

During blockades, the drug can be injected into different places:

• into bone tissue;
• into muscle tissue;
• into the joint area.

If it is necessary to quickly respond and eliminate acute pain, blockades are used

Plasters

The use of special patches for radiculitis ensures a long-term warming effect . However, if worn for a long time and/or if you sweat a lot, the patches may cause redness.

If the use of the patch is accompanied by a strong burning sensation, you should immediately remove it from the surface of the skin in order to avoid burns.

Ointments, gels, creams

It is impossible to imagine comprehensive treatment of radiculitis without topical medications. Ointments, creams and gels may contain irritants and anti-inflammatory agents . They have a warming effect and help eliminate local manifestations of the disease (paresthesia, numbness).