Anticoagulant rodenticides poisoning

Definition

Anticoagulant rodenticides are poisons used to kill rats. Rodenticide means rodent killer. An anticoagulant is a blood thinner.

Anticoagulant rodenticide poisoning occurs when someone swallows a product containing these chemicals.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Alternative Names

Rat killer poisoning; Rodenticide poisoning

Poisonous Ingredient

• 2-iso-valeryl-1,3-indandione
• 2-pivaloyl-1,3-indandione
• Brodifacoum
• Chlorophacinone
• Coumachlor
• Difenacoum
• Diphacinone
• Warfarin

Note: This list may not be all-inclusive.

Where Found

• D-Con, Mouse Prufe II, Talon (Brodifacoum)
• Ramik, Diphacin (Diphacinone)

Note: This list may not be all-inclusive.

Symptoms

• Blood in the urine
• Bloody stools
• Bruising and bleeding under the skin
• Confusion, lethargy, or altered mental status from bleeding in the brain
• Low blood pressure
• Nosebleed
• Pale skin
• Shock
• Vomiting blood

Home Treatment

DO NOT make a person throw up unless told to do so by Poison Control or a health care professional.

Before Calling Emergency

Determine the following information:

• Patient's age, weight, and condition
• The name of the product (ingredients and strengths if known)
• Time it was swallowed
• How much was swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The patient may receive:

• Blood transfusion if too much blood has been lost
• Endoscopy -- camera down the throat to see the esophagus and the stomach
• Fluids through a vein (IV)
• Medicines to treat symptoms
• Medicine to absorb any remaining poison
• Medicine (antidote) to reverse the effect of the poison

Expectations (prognosis)

Death may occur as late as 2 weeks after the poisoning as a result of bleeding. However, adequate treatment usually prevents any serious complications.

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References

Hack JB, Hoffman RS. General management of poisoned patients. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 156.