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Bromadiolone toxicokinetics: diagnosis and treatment implications
Vanessa M H Lo1, C K Ching, Albert Y W Chan
1Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Hong Kong, Special Administrative Region, China.
Clinical Toxicology (Philadelphia, Pa.)
|February 25, 2009
Summary
Bromadiolone poisoning can cause severe bleeding disorders. This case study reveals bromadiolone has a half-life of 24 days, and low plasma levels correlate with normal coagulation, aiding treatment decisions.
Area of Science:
- Toxicology
- Pharmacokinetics
- Clinical Chemistry
Background:
- Bromadiolone rodenticide ingestion causes severe coagulopathy.
- Limited data exists on bromadiolone elimination kinetics and half-life in humans.
- Current treatment monitoring relies on coagulation profiles.
Observation:
- A case of bromadiolone poisoning in a 40-year-old female is presented.
- Serial plasma bromadiolone levels were measured following ingestion.
- The patient presented with significantly elevated prothrombin time and international normalized ratio.
Findings:
- Bromadiolone elimination follows a two-compartment model.
- The rapid elimination phase half-life is 3.5 days, and the terminal phase half-life is 24 days.
- Plasma bromadiolone levels below 10 ng/mL correlated with normal coagulation without vitamin K1 therapy.
Implications:
- Plasma bromadiolone levels may offer a more precise endpoint for vitamin K1 therapy.
- Further research is needed to establish plasma bromadiolone levels as a reliable therapeutic endpoint.
- Understanding bromadiolone toxicokinetics can improve patient management.
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