Case of the month: "Oh! Drat!--A case of transcutaneous superwarfarin poisoning and its recurrent presentation"

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

“…Lastly, cases of transcutaneous toxic exposure have been reported in association with liquid forms of chlorphacinone and diphacinone spilled onto skin or clothing. For instance, an 18-year-old man spilled a solution containing diphacinone into his boot, and subsequently, he developed flank pain and hematuria [13,53].…”

“…Of note, 10 (71%) of the 14 deaths from case report data were associated with intracranial hemorrhage, and of the 10 reported cases of intracranial hemorrhage, only 1 (10%) survived. Within this closer review of LAAR exposures, brodifacoum was the most common offending agent-brodifacoum, 83/174 (48%); chlorophacinone, 24/174 (14%); LAAR not otherwise 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 specified, 67/174 (38%) [2][3][4][5][6][7][8]13,17,20,27,32,33,[38][39][40][41]43,[49][50][51]53,.…”

“…Multiple cases have been reported in which patients presented with bleeding or abnormal coagulation assays that were initially corrected by treatment with vitamin K [13,53]. Most clinicians are familiar with the treatment of supratherapeutic INRs during warfarin anticoagulation.…”

Medicinal Potentials and Toxicity Concerns of Bioactive Principles

“…The coumarins are antimicrobial, anti-inflammatory [193][194][195], antioxidant [106,112,193,[196][197][198][199], anti-diabetic [198,200], hepatoprotective [198], anti-thrombotic [193,196,201], anti-fungal [193,195], anti-viral [112], analgesic [195] and anti-carcinogenic [152,202,203] agents.…”

Superwarfarin intoxication via skin exposure causing high INR levels and vitamin K deficiency: A case report

“…Olgumuzda kullanılan superwarfarinli rodentisitte brodifacoum etken maddesi vardır. Sıçanlar üzerinde yapılan bir araştırmada, warfarinin yarı ömrü 17 saat olarak saptamışken, superwarfarinli rodentisit olan brodifacoumun yarı ömrü 156 saat olarak saptamıştır (6) . Superwarfarinin vücuttan atıl-ması haftalarca sürebilmektedir.…”