Differential action of Indian Big Four snake venom toxins on blood coagulation

Snake venom toxins affect hemostasis by modulating blood coagulation factors resulting in pro/anti-coagulant status of blood. Most of the reported effects are in vitro which do not reflect in-vivo coagulation status. The specific interference of venom toxins on coagulation factor(s) in vivo can be used as a marker to identify the snake species responsible for envenomation and administration of species-specific anti-venom thereafter. The current review attempts to highlight specific alterations induced by BIG FOUR venomous snakes of India towards blood coagulation factors. Future insights in this regard will be valuable in identifying the snake species responsible for bite which in most cases is unknown