Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Tran, Minh‐Ha

doi:10.1016/j.tmrv.2015.06.002

Cited by 97 publications

(124 citation statements)

References 87 publications

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“…The diagnosis of rodenticide intoxication has to be considered for any patient with prolonged prothrombin time (increased INR), prolonged activated partial prothrombin time; the vitamin K-dependent factor II, VII, X, IX coagulant activities are decreased while factor V coagulant activity and the ibrinogen level are normal [41,43,47,48]. Liver dysfunction, cholestasis and severe starvation can be ruled out by normal liver enzymes and serum albumin concentration.…”

Section: Clinical Outcomes and Laboratory Diagnosismentioning

confidence: 99%

Poisoning by Anticoagulant Rodenticides in Humans and Animals: Causes and Consequences

Lefebvre¹,

Fourel²,

Queffélec³

et al. 2017

Poisoning - From Specific Toxic Agents to Novel Rapid and Simplified Techniques for Analysis

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Anticoagulant rodenticides (ARs) are a keystone of the management of rodent populations in the world. The widespread use of these molecules raises questions on exposure and intoxication risks, which deine the safety of these products. Exposures and intoxications can afect humans, domestic animals and wildlife. Consequences are diferent for each group, from the simple issue of intoxication in humans to public health concern if farm animals are exposed. After a rapid presentation of the mechanism of action and the use of anticoagulant rodenticides, this chapter assesses the prominence of poisoning by anticoagulant rodenticides in humans, domestic animals and wildlife.

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Section: Clinical Outcomes and Laboratory Diagnosismentioning

confidence: 99%

Poisoning by Anticoagulant Rodenticides in Humans and Animals: Causes and Consequences

Lefebvre¹,

Fourel²,

Queffélec³

et al. 2017

Poisoning - From Specific Toxic Agents to Novel Rapid and Simplified Techniques for Analysis

View full text Add to dashboard Cite

show abstract

“…[10] In contrast to typical doses of vitamin K used for warfarin reversal-1-5 mg PO for nonbleeding patients, 5-10 mg PO/IV for bleeding patients, [87] therapeutic vitamin K doses for LAAR poisoning are 10-20 fold higher. In addition, duration of treatment involves extended courses (median of 140 days, range 28-790 days) of high dose vitamin K, with mean maintenance (per oral) doses of 100 mg daily (median 60 mg, range 15-600).…”

Section: Treatment Of Laar Poisoningmentioning

confidence: 99%

“…[10] Patients with apparent response followed by recrudescence of coagulopathy may represent resumption of surreptitious LAAR consumption, and psychiatric consultation, particularly with suicidal patients is recommended. [10] The requirement for long-term therapy is directly related to the extended half-lives of these agents. Whereas warfarin is associated with a half-life of 17-37 hours, the half-lives of difenacoum and brodifacoum are 11.5 days and up to 34 days, respectively.…”

Section: Treatment Of Laar Poisoningmentioning

confidence: 99%

“…Whereas warfarin is associated with a half-life of 17-37 hours, the half-lives of difenacoum and brodifacoum are 11.5 days and up to 34 days, respectively. [10] …”

Section: Treatment Of Laar Poisoningmentioning

confidence: 99%

“…Accumulation of Vitamin K Epoxide may be present and the diagnosis confirmed by specific testing for presence of rodenticides. [10] Figure 1. Vitamin K cascade and sites of VKA/LAAR antagonism Long-acting anticoagulant rodenticides are readily available at home supply stores for around-the-house use by consumers.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and symptomatology of long acting anticoagulant rodenticide poisoning

Tran

2015

JER

Self Cite

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Background: Long acting anticoagulant rodenticides (LAARs) are widely used pesticides that initiate anticoagulation through a vitamin K antagonist (VKA) mechanism. Human exposures produce presentations ranging from asymptomatic to fatal. Methods: A comprehensive literature search and search of relevant databases was conducted. Data related to epidemiology of LAAR exposure as well as clinical manifestations of LAAR poisoning and clinical management were extracted. Results: Between 1987 and 2012, 315,951 total exposures were reported to the American Association of Poison Control Centers. Of these, 95.6% were unintentional and 88.9% occurred in children under the age of six. Moderate or major effects occurred in only 0.6% of human LAAR exposures. Of reviewed case reports, the most common hemorrhagic manifestations were mucocutaneous. Fatalities were most commonly associated with intracranial hemorrhage and intentional misuse. Multiple routes of exposure have been reported including oral, percutaneous, and inhalational. Treatment courses required prolonged administration of high dose vitamin K. Conclusions: Most instances represent unintentional LAAR exposures among children. Although the majority of exposures are asymptomatic, serious coagulopathy may occur, and LAAR poisoning may not immediately be considered as an etiology. A heightened awareness for this entity and awareness of diagnosis and treatment principles are critical to appropriate management.

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Rodenticides

Semino

2023

Patty's Toxicology

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Rodenticides are chemicals used for the control of mammal pests, particularly commensal rats and mice but also a variety of field rodents. There are many different active ingredient s ( AI s) used as rodenticides and they vary widely in the hazard they present. They are mainly used in baits and to limited extent applied as fumigant. Rodenticides used in baits are broadly classified into two categories: anticoagulants and nonanticoagulant acute poisons. Rodent pest control worldwide relies largely on the use of anti‐vitamin K (AVK) anticoagulants. They interfere with the activation of vitamin K, a critical component in the production of blood clotting factors in the liver. The anticoagulants are themselves separated into first‐generation (much more toxic when feeding occurs on several successive days rather than on 1 day only) and second‐generation chemicals (which can kill after a single night feeding and tend to remain in animal tissues longer than do first‐generation ones). Nonanticoagulant rodenticides act through various mechanism of action. Bromethalin poisons the central nervous system (CNS) and ultimately causes respiratory distress following ingestion of a single dose. Cholecalciferol, the biologically active form of vitamin D, induces hypercalcemia (elevated blood calcium levels), which ultimately results in heart problems and kidney failure. Zinc phosphide liberates toxic phosphine gas upon interaction with stomach acid, leading to rodent mortality within few hours from ingestion. Except for Alphachloralose for mice control, the other rodenticides, formally referred to as the acute toxicants (e.g., arsenic, red squill, and phosphorus) are either no longer registered or of little importance in commensal rodent control. Products containing substances applied by fumigation (like carbon dioxide, hydrogen cyanide, and aluminum phosphide) are strictly reserved for rodent control professionals. As rodenticides are generally nonselective animal poisons, they carry a few serious risks to other vertebrate species and are frequently the cause of unintended consequences, from the stench of rodents decomposing in the walls to poisonings of nontarget organisms. Primary poisoning can result from wild birds and pets, while secondary poisoning of birds and mammals (including dogs and cats) can accompany the ingestion of poisoned rodents. Human incident data sources report numerous incidents, especially involving children less than 6 years old, so that human exposure to rodenticides may result in severe outcomes and/or medical care. Therefore in the last two decades, risk mitigation measures ( RMM ) and integrated pest management ( IPM ) strategies have been adopted worldwide. These measures require rodenticide products used in homes and marketed to general residential consumers to be sold only with bait stations that contain and/or are packaged with a rodenticide bait that is in block or paste form and accredited training programs are carried out for professional use rodenticides. Moreover, regulatory authorities conduct periodical re‐evaluations of registered rodenticides to ensure they meet modern health and safety standards to remain in the market.

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Long-Acting Anticoagulant Rodenticide (Superwarfarin) Poisoning: A Review of Its Historical Development, Epidemiology, and Clinical Management

Cited by 97 publications

References 87 publications

Poisoning by Anticoagulant Rodenticides in Humans and Animals: Causes and Consequences

Poisoning by Anticoagulant Rodenticides in Humans and Animals: Causes and Consequences

Epidemiology and symptomatology of long acting anticoagulant rodenticide poisoning

Rodenticides

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