AVP and Hyponatremia: Individuals with acute Kambô toxicity may present with hyponatremia due to the combination of ritualistically encouraged consumption of two to four liters of hypotonic water, intended to enhance purging, and the peptide-mediated activation of CCK-A and NK1 receptors by phyllocaerulein and phyllomedusin, which induce intense nausea, vomiting, and gastrointestinal fluid loss; these effects, coupled with sauvagine-induced CRF1 receptor activation, stimulate non-osmotic ADH release, further impairing free water excretion and exacerbating electrolyte imbalances.