Mitigating cardiotoxicity of Naja naja venom: Evaluation of a multipronged strategy using anti-snake venom and methanolic extract of Andrographis paniculata

This study assesses the effect of anti-snake venom (ASV), methanolic extract of Andrographis paniculata (MAP), and ASV+MAP (50% reduced dose of ASV+MAP) in mitigating cardiotoxicity in rats. Thirty female Wistar rats were divided into five groups (n = 6): normal control, venom control (VC), and three test groups treated with ASV or MAP or ASV+MAP. Electrocardiogram was recorded at baseline, 30, 90 minutes, 24 hours, and days 7 and 14. Serum creatine kinase (CKMB) levels were measured at baseline, 24 hours, and days 7 and 14. On day 15, animals were sacrificed for histopathological analysis. Bradycardia occurred at 90 minutes in all groups except the ASV+MAP group. The amplitude of the P wave improved maximally with ASV+MAP. CKMB, which was high in the VC group, was reduced by ASV to the extent of 20% and ASV+MAP by 30%. On day 14, a decrease in CKMB was observed in all groups, lowest being the ASV+MAP group. Histopathological changes observed in the VC group were attenuated by ASV+MAP. The multipronged approach of administering MAP along with a 50% reduced dose of ASV was shown to be the best strategy for mitigating cardiotoxicity of Naja naja venom.