[Poisoning with long-acting anticoagulants]

Area of Science:

• Toxicology
• Pharmacology

Background:

• Norway's rodenticides previously contained anticoagulants like warfarin.
• Manufacturers now use "superwarfarins" in rodenticides.
• Superwarfarins are more toxic to humans than warfarin.

Observation:

• Two patients were poisoned by bromadiolone, a superwarfarin.
• One patient required six months of vitamin K1 treatment.
• Literature review indicates similar cases.

Findings:

• Superwarfarins cause prolonged anticoagulatory effects.
• A single dose can last 50-60 days; prolonged intake can extend to seven months.
• Bromadiolone poisoning necessitates extended vitamin K1 therapy.

Implications:

• Increased toxicity of modern rodenticides poses significant public health risks.
• Extended treatment protocols are crucial for managing superwarfarin poisoning.
• Clinical guidance on managing rodenticide poisoning requires updates.