The 'Big Four’ Snakes of India: Venom Composition, Pharmacological Properties and Treatment of Envenomation

Preface
Contents
About the Author
1: Introduction
	1.1 A Glimpse of the Venomous Snakes of India
	1.2 The Concept of the ``Big Four´´ and Non-``Big Four´´ Medically Important Venomous Snakes of India
	1.3 Medical Aspects of Snakebite: The Snakebite Problem
		1.3.1 Snakebite in Developed Countries
		1.3.2 Epidemiology of Snakebite in Asia
		1.3.3 Epidemiology of Snakebite in India
	1.4 Key Issues Pertaining to Snakebite in India
	References
2: Evolution of Snakes and Systematics of the ``Big Four´´ Venomous Snakes of India
	2.1 Evolution of Snakes
	2.2 Studies of the Genomics, Phenomics, and Fossil Record Show the Origin and Evolution of Snakes
	2.3 Studies on the Genomic Regression of Claw Keratin, Taste Receptors, and Light-Associated Genes and the Evolutionary Origin...
	2.4 Skull Evolution and the Ecological Origin of Snakes
	2.5 Systematics of the ``Big Four´´ Venomous Snakes of India
	2.6 The ``Big Four´´ Venomous Snakes of India Represent the Advanced Group of Snakes
		2.6.1 Family Elapidae
			2.6.1.1 Genus Bungarus (Kraits)
			2.6.1.2 Genus Naja (Cobras)
		2.6.2 Family Viperidae
			2.6.2.1 Genus Daboia
			2.6.2.2 Genus Echis
	References
3: Snake Venom: Composition, Function, and Biomedical Applications
	3.1 The Venom Gland and Venom Delivery Apparatus in the Viperidae and Elapidae Families of Snakes
	3.2 Comprehensive Review of the Venom Composition of the ``Big Four´´ Venomous Snakes of India
		3.2.1 Enzymatic Toxins of the ``Big Four´´ Snake Venoms
		3.2.2 Nonenzymatic Toxins in the ``Big Four´´ Snake Venoms
		3.2.3 Nonprotein Components of Snake Venom
	3.3 Variation in Snake Venom Composition and Its Impact on the Pathogenesis of Snakebite and Antivenom Treatment
	3.4 Evolution of Genes for the Toxins in Snake Venom
		3.4.1 Toxicofera Hypothesis
		3.4.2 Independent Origin Hypothesis
	3.5 Mechanism of the Evolution and Diversification of Venom Proteins
		3.5.1 Accelerated Evolution of Venom Protein Genes
		3.5.2 Selection Pressure for Rapid Adaptive Evolution
		3.5.3 Diet and Snake Venom Evolution
	3.6 Biological Functions of Venom
		3.6.1 Prey-Specific Venom Toxicity
		3.6.2 Immobilization and Predigestion of Prey
		3.6.3 Prey Re-localization
	3.7 Indian Snake Venom Proteins: A Treasure House of Drug Prototypes and Diagnostic Tool
	References
4: Indian Spectacled Cobra (Naja naja)
	4.1 Taxonomic Classification of the Indian Spectacled Cobra (Naja naja)
	4.2 Characteristic Features of the Indian Spectacled Cobra
	4.3 Geographical Distribution and Reproduction of the Indian Spectacled Cobra
	4.4 Biochemical Composition of the Indian Spectacled Cobra Venom
	4.5 Biochemical and Proteomic Analyses to Demonstrate the Geographical Differences in Venom Composition of Indian Spectacled C...
	4.6 Genomic and Transcriptomic Analyses of Indian Spectacled Cobra Venom Toxins
	4.7 Species-Specific Differences in the Venom Composition Between N. naja and N. kaouthia from the Same Geographical Location ...
	4.8 Pharmacology, Pathophysiology, and Clinical Features of Indian Spectacled Cobra Envenomation
	References
5: Indian Common Krait (Bungarus caeruleus)
	5.1 Taxonomic Classification of the Indian Common Krait (Bungarus caeruleus)
	5.2 Characteristic Features of the Indian Common Krait
	5.3 Geographical Distribution, Habitat, Behavior, and Reproduction of the Indian Common Krait
	5.4 Venom Composition of the Indian Common Krait
	5.5 Pharmacology, Pathophysiology, and Clinical Features of the Indian Common Krait Envenomation
	References
6: Indian Russell´s Viper (Daboia russelii)
	6.1 Taxonomic Classification of Indian Russell´s Viper (Daboia russelii)
	6.2 Characteristic Features of the Indian Russell´s Viper
	6.3 Geographical Distribution, Habitat, and Reproduction of Indian Russell´s Viper
	6.4 Composition of Indian Russell´s Viper Venom
	6.5 Pharmacology, Pathophysiology, and Clinical Features of Envenomation by Indian Russell´s Viper
	References
7: Indian Saw-Scaled Viper (Echis carinatus carinatus)
	7.1 Taxonomic Classification of the Indian Saw-Scaled Viper (Echis carinatus carinatus)
	7.2 Characteristic Features of the Indian Saw-Scaled Viper
	7.3 Geographic Distribution, Habitat, Behavior, and Reproduction of the Indian Saw-Scaled Viper
	7.4 Composition of the Indian Saw-Scaled Viper Venom
	7.5 Pharmacology, Pathophysiology, and Clinical Features of Envenomation by the Indian Saw-Scaled Viper
	References
8: Prevention and Treatment of the ``Big Four´´ Snakebite in India
	8.1 Prevention of Snakebite: Some Useful Strategies
	8.2 First Aid for Snakebite
		8.2.1 First Aid for Snakebite: World Health Organization-Recommended Guidelines
	8.3 Antivenom Production in India
		8.3.1 Monovalent vs. Polyvalent Antivenom
		8.3.2 Production of F(ab′)2 PAV in India
		8.3.3 Quality Control of Commercial Antivenom: World Health Organization Guidelines
			8.3.3.1 In Vitro Laboratory Tests
			8.3.3.2 Preclinical Tests on Experimental Animal Models
			8.3.3.3 Clinical Tests on Volunteers
	8.4 Diagnosis and Clinical Treatment of Snakebite
	8.5 Management of Adverse Effects of Antivenom
		8.5.1 Early Adverse Reactions
		8.5.2 Endotoxin-Mediated Pyrogenic Reactions
		8.5.3 Late Serum Reactions
		8.5.4 Prevention and Treatment of Adverse Serum Reactions
	8.6 Geographical and Species-Specific Variation in Snake Venom Composition and Its Impact on Antivenom Treatment
	References