Related Experiment Video

Updated: Aug 17, 2026

A Chronic Cardiac Ischemia Model in Swine Using an Ameroid Constrictor
08:22

A Chronic Cardiac Ischemia Model in Swine Using an Ameroid Constrictor

Published on: October 9, 2017

Surreptitious superwarfarin ingestion with brodifacoum

R G Berry1, J A Morrison, J W Watts

  • 1Columbus County Hospital, Whiteville, NC, USA.

Southern Medical Journal
|February 1, 2000
PubMed

Insights

Physicians should suspect uncommon causes of bleeding, like rodenticide ingestion, when standard tests are negative. Brodifacoum, a warfarin-like rodenticide, can cause prolonged bleeding without detectable warfarin levels.

Area of Science:

  • Toxicology
  • Hematology

Background:

  • Unexplained bleeding and prolonged prothrombin time (PT) in patients warrant thorough investigation.
  • Standard warfarin assays may not detect anticoagulant rodenticides.

Observation:

  • A patient presented with a history of unexplained bleeding and elevated PT.
  • Warfarin levels were consistently undetectable.

Findings:

  • The patient's symptoms were attributed to surreptitious ingestion of brodifacoum, a potent anticoagulant rodenticide.
  • Brodifacoum is a modified warfarin derivative not detected by standard warfarin assays.

Implications:

  • Clinicians must consider non-standard anticoagulant exposures in cases of unexplained bleeding.
  • Diagnostic assays for anticoagulant rodenticides should be considered in specific clinical scenarios.

More Related Videos

Ferric Chloride-Induced Arterial Thrombosis and Sample Collection for 3D Electron Microscopy Analysis03:57

Ferric Chloride-Induced Arterial Thrombosis and Sample Collection for 3D Electron Microscopy Analysis

Published on: March 17, 2023

Establishment of a Modified Ferric Chloride-Induced Superior Sagittal Sinus Thrombosis07:34

Establishment of a Modified Ferric Chloride-Induced Superior Sagittal Sinus Thrombosis

Published on: December 30, 2025

Related Concept Videos

Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...