Some medically important snakes found in North America

For guidance on treating North American snake bites, including indications for giving antivenom, specific antivenom to use, and dosing, consult a regional poison control center (in the United States, call 1-800-222-1222) or contact a physician with expertise in treating venomous snake bites.
Common name	Scientific name	Common effects	Less common effects
Rattlesnakes	Crotalus or Sistrurus spp	Local (bite site): Pain Swelling Erythema Ecchymosis Hemotoxicity*	Nausea and vomiting Neurotoxicity^¶ Bleeding Shock Rhabdomyolysis Tissue necrosis Compartment syndrome Venom angioedema
Cottonmouths (water moccasins)	Agkistrodon piscivorus	Local only as above	Hemotoxicity* Other uncommon effects as above are possible but less likely
Copperheads	Agkistrodon contortrix	Local only as above
Coral snakes	Micrurus spp	Paresthesias Local pain and swelling	Nausea and vomiting Dizziness Myalgia Neurotoxicity: Salivation Lethargy Weakness (typically beginning with ocular and bulbar weakness with progression to generalized muscle weakness)^Δ Respiratory failure secondary to weakness

For more information on the clinical manifestations, diagnosis, and treatment of bites by these snakes, including available antivenoms, refer to UpToDate content on bites by Crotalinae snakes (rattlesnake, water moccasin [cottonmouth], or copperhead) or coral snakebites. Geographic distribution of specific snake species may be found at Toxinology snake search.

* Hemotoxicity includes thrombocytopenia, hypofibrinogenemia, prolonged prothrombin time (PT), and/or bleeding.

¶ Neurotoxic effects include perioral and extremity paresthesias and myokymia (rippling muscle movement often seen in the face and proximal extremity muscle groups; frequently characterized as fasciculations in snakebite literature). Myokymia or fasciculations are most often reported after bites by the timber rattlesnake (Crotalus horridus) but also occur after envenomation by many western rattlesnake species. Severe weakness and paralysis after a rattlesnake bite are rare but associated with envenomation by some populations of Mohave rattlesnakes (Crotalus scutulatus) and Southern Pacific rattlesnakes (Crotalus helleri).

Δ Neurotoxicity after coral snakebites may occur more than 12 hours after the bite. Initial signs include ptosis, ophthalmoplegia, dysarthria, and dysphagia.

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Some medically important snakes found in North America