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

作者: Nathan King , Minh-Ha Tran

DOI: 10.1016/J.TMRV.2015.06.002

关键词:

摘要: Long-acting anticoagulant rodenticides (LAARs) inhibit vitamin K epoxide reductase (VKOR). Related bleeding may present a diagnostic challenge and require administration of blood component therapy, hemostatic agents, K. This article intends to provide the reader comprehensive understanding LAAR poisoning. An exhaustive literature search PubMed, Science Direct, US National Library Medicine Toxicology Data Network, Google Scholar yielded 174 reported cases poisoning from which clinical data were extracted reviewed. In addition, 25 years epidemiologic American Association Poison Control Centers was United States, on average, there 10413 exposures with 2750 patients treated annually. For years, 315951 nearly 90% among children more than 100000 in health care facility. Fortunately, only 2% all result morbidity or mortality. Inhalational, transcutaneous, oral routes exposure have been documented. Most are unintentional. The most frequently sites mucocutaneous, hematuria being common feature. Deaths commonly associated intracranial hemorrhage. rodenticide-induced paradoxical thrombosis thrombotic complications accompanying therapy also observed. coagulation assay values beyond measurable limits. an extremely high affinity for VKOR compared warfarin, characterized by rebound coagulopathy after initial treatment need high-dose, long-term K1. Treatment acute hemorrhagic symptoms often required intravenous K1 excess 50 100 mg; chronic maintenance mg PO daily used dose suppress coagulopathy. courses averaged 168 days. Adjunctive recombinant factor VIIa prothrombin complex concentrate has reported, phenobarbital expedite metabolism.

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