Long-acting anticoagulant rodenticide poisoning: An evidence-based consensus guideline for out-of-hospital management

Caravati, E. Martin; Erdman, Andrew R.; Scharman, Elizabeth J.; Woolf, Alan D.; Chyka, Peter A.; Cobaugh, Daniel J.; Wax, Paul M.; Manoguerra, Anthony S.; Christianson, Gwenn; Nelson, Lewis S.; Olson, Kent R.; Booze, Lisa L.; Troutman, William G.

doi:10.1080/15563650600795487

Cited by 61 publications

(74 citation statements)

References 46 publications

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“…[67][68][69][70] Most patients can be managed in the outpatient setting as long as the ingestion has been recognized early. 71 Treatment is vitamin K and should be reserved for patients with elevated PT (INR) levels or active bleeding. With severe bleeding or shock, a transfusion of blood or plasma is indicated as well.…”

Section: Rodenticides (Long-acting Anticoagulants)mentioning

confidence: 99%

Pesticide Exposure in Children

Roberts¹,

Karr²,

Paulson³

et al. 2012

Pediatrics

241

106

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Pesticides are a collective term for a wide array of chemicals intended to kill unwanted insects, plants, molds, and rodents. Food, water, and treatment in the home, yard, and school are all potential sources of children’s exposure. Exposures to pesticides may be overt or subacute, and effects range from acute to chronic toxicity. In 2008, pesticides were the ninth most common substance reported to poison control centers, and approximately 45% of all reports of pesticide poisoning were for children. Organophosphate and carbamate poisoning are perhaps the most widely known acute poisoning syndromes, can be diagnosed by depressed red blood cell cholinesterase levels, and have available antidotal therapy. However, numerous other pesticides that may cause acute toxicity, such as pyrethroid and neonicotinoid insecticides, herbicides, fungicides, and rodenticides, also have specific toxic effects; recognition of these effects may help identify acute exposures. Evidence is increasingly emerging about chronic health implications from both acute and chronic exposure. A growing body of epidemiological evidence demonstrates associations between parental use of pesticides, particularly insecticides, with acute lymphocytic leukemia and brain tumors. Prenatal, household, and occupational exposures (maternal and paternal) appear to be the largest risks. Prospective cohort studies link early-life exposure to organophosphates and organochlorine pesticides (primarily DDT) with adverse effects on neurodevelopment and behavior. Among the findings associated with increased pesticide levels are poorer mental development by using the Bayley index and increased scores on measures assessing pervasive developmental disorder, inattention, and attention-deficit/hyperactivity disorder. Related animal toxicology studies provide supportive biological plausibility for these findings. Additional data suggest that there may also be an association between parental pesticide use and adverse birth outcomes including physical birth defects, low birth weight, and fetal death, although the data are less robust than for cancer and neurodevelopmental effects. Children’s exposures to pesticides should be limited as much as possible.

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Section: Rodenticides (Long-acting Anticoagulants)mentioning

confidence: 99%

Pesticide Exposure in Children

Roberts¹,

Karr²,

Paulson³

et al. 2012

Pediatrics

241

106

View full text Add to dashboard Cite

show abstract

“…To reduce the tremendous variability in triage practices [15], 17 US national triage guidelines were published from 2003 to 2008, but address only 107 ingredients [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Most substances are not covered by national guidelines, and most poison centers have only a limited set of additional site-specific guidelines; thus, there is a high degree of triage variability both between and within centers and considerable time spent reassessing toxicity each time an exposure occurs.…”

Section: Discussionmentioning

confidence: 99%

webPOISONCONTROL: can poison control be automated?

Litovitz

Benson

Smolinske

2016

The American Journal of Emergency Medicine

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“…In adults, exposures are more likely to be intentional, with documented cases including Munchausen syndrome, Munchausenby-proxy, lacing of illicit drugs, suicide attempts, and murder [13,22,25,32,49,50]. In a review of data from the AAPCC's Toxic Exposure Surveillance System from 2000 to 2003, unintentional exposures had a 39-fold greater association with minor to no effects when compared with intentional exposures [13]. In cases of adult exposure where the nature of exposure remains obscure, many experts recommend psychiatric evaluation [7,21].…”

Section: Routes Of Exposurementioning

confidence: 98%

“…The biologic effects of secondgeneration agents are thought to be attributable to their high lipid solubility and increased affinity for hepatic tissue and hepatic enzymes [4,7,18]. Given their dramatic increase in toxicity, the term Examples of LAARs [12,13] superwarfarin was coined in the 1970s to describe these agents. Brodifacoum is the most potent of the second-generation anticoagulants.…”

Section: The Development Of Laarsmentioning

confidence: 99%