also has two neurotoxins—an alpha-toxin that is a post-synaptic inhibitor and a beta-toxin that is a pre-synaptic inhibitor. Because the beta-toxin acts pre-synaptically, its effects cannot be blocked or treated by anticholinesterases. The venom contains an anticoagulant, mamushi L-amino-acid oxidase (M-LAO). It also contains the peptide ablomin which is highly similar in amino acid sequence to that of the venom, helothermine, of the Mexican beaded lizard (Heloderma horridum). Treatments for envenomations There is an effective antivenom manufactured in both Japan and China. Its effectiveness is increased when co-administered with a serine protease inhibitor such as FOY (see, e.g. Camostat). In common with many other venomous snakes, the mamushi is highly resistant to its own venom because of various neutralising factors present in its sera including phospholipase A2 (PLA2) inhibitors; these and other inhibitors are the target of antivenom development. Every year, 2000-3000 people in Japan are bitten by mamushi, severe bites require intensive care, and approximately 10 victims die. There have been case reports of kidney failure, visual disturbances, palsy, and miscarriage in pregnant women. In one study in Japan, mamushi bite victims required a median duration of 7 days of hospital treatment followed by a median of 31 days of out-patient treatment; the time to achieve a full recovery was even longer, taking up to several months. The treatment protocol involved incision of the wound for exclusion of the venom, and injection of mamushi antivenom. Taxonomy This species is similar to the cottonmouths and copperheads (Agkistrodon sp.) of the Americas, and it was long considered part of the same group (see synonymy). References Further reading Boie H (1826). "Merkmale eineger japanischer Lurche ". Isis von Oken 19: 203-216. (Trigonocephalus blomhoffii, new species, pp. 214–215). (in German and Latin). External links Gloydius blomhoffii at the Encyclopedia of Japanese Reptiles. Accessed 20 December 2007. Gloydius Endemic reptiles of Japan Reptiles described in 1826