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Anticoagulant rodenticide poisoning: Clinical manifestations and diagnosis

Author
Diane P Calello, MD
Section Editor
Michele M Burns, MD, MPH
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

This topic reviews the clinical manifestations and diagnosis of anticoagulant rodenticide poisoning.

The management of anticoagulant rodenticide poisoning and an overview of rodenticide poisonings other than anticoagulant rodenticides is provided separately. (See "Overview of rodenticide poisoning".)

EPIDEMIOLOGY

Anticoagulant compounds are the most commonly used rodenticides in most of the world. The process of controlling rodent populations is imperative to human health but poses challenges when the rodenticide compounds used are also toxic to humans and domestic animals. The ideal rodenticide is highly toxic to rodents in small amounts but relatively nontoxic in small quantities to non-target species. The anticoagulant rodenticides best fit this criteria [1]. Anticoagulant rodenticides came into use in the 1940s with the use of warfarin. The emergence of warfarin-resistant rats prompted the development of superwarfarins, or long-acting anticoagulants such as brodifacoum, bromadiolone, and chlorophacinone. Because of their availability, anticoagulant rodenticides are also the most common cause of rodenticide poisoning exposures reported annually in resource-rich countries such as the United States and the United Kingdom [2,3].

In the United States, brodifacoum is the most frequently used anticoagulant rodenticide [4]; however, global differences exist. In the United Kingdom, difenacoum, brodifacoum, and bromadiolone are most common [5]. In the developing world, the use of warfarin rodenticides has led to tragic inadvertent exposures in newborns as well as the ingestion of contaminated foodstuff with resultant fatalities [6,7].

Throughout the world, the overwhelming majority of anticoagulant rodenticide exposures occur in young children, who generally ingest small volumes and have no significant coagulopathy [4,7-9]. However, patients with intentional or occupational exposures develop coagulopathy much more frequently.

               

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Literature review current through: Nov 2016. | This topic last updated: Mon Jul 25 00:00:00 GMT 2016.
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