Fixed dose 4-factor prothrombin complex concentrate for bleeding caused by long acting anticoagulant rodenticides

Am J Emerg Med. 2018 Oct;36(10):1922.e3-1922.e4. doi: 10.1016/j.ajem.2018.06.040. Epub 2018 Jun 18.

Abstract

Acute, unintentional drug-related poisonings lead to an estimated 418,313 ED visits in 2014, according to the latest statistics from the Center for Disease Control and Prevention. While most of these were opiate-related poisonings, anticoagulant rodenticides were the most common cause of rodenticide-related poisoning in the United States. Many clinical syndromes and treatment algorithms have been described for patients with anticoagulant rodenticide poisoning. We report a case of an acute ingestion of two anticoagulant rodenticides and successful reversal of coagulation parameters using 4-factor prothrombin complex concentrate in a fixed-dose approach.

Keywords: Brodifacoum; Difenacoum; Prothrombin complex concentrates; Rodenticides.

MeSH terms

  • 4-Hydroxycoumarins / poisoning*
  • Abdominal Pain / chemically induced
  • Aged
  • Anticoagulants / adverse effects*
  • Blood Coagulation Disorders / chemically induced
  • Blood Coagulation Factors / administration & dosage*
  • Drug Contamination
  • Drug Dosage Calculations
  • Hemorrhage / chemically induced*
  • Hemorrhage / drug therapy
  • Humans
  • Illicit Drugs / poisoning*
  • Male
  • Rodenticides / poisoning*
  • Synthetic Drugs / adverse effects*
  • Treatment Outcome
  • Vitamin K / administration & dosage*

Substances

  • 4-Hydroxycoumarins
  • Anticoagulants
  • Blood Coagulation Factors
  • Illicit Drugs
  • Rodenticides
  • Synthetic Drugs
  • Vitamin K
  • prothrombin complex concentrates
  • bromfenacoum