@article{ref1,
title="Long-acting anticoagulant overdose: brodifacoum kinetics and optimal vitamin K dosing",
journal="Annals of emergency medicine",
year="2000",
author="Bruno, G. R. and Howland, M. A. and McMeeking, A. and Hoffman, R. S.",
volume="36",
number="3",
pages="262-267",
abstract="Ingestion of long-acting anticoagulant rodenticides such as brodifacoum can lead to prolonged and life-threatening coagulopathy. A paucity of conflicting information is available on brodifacoum's half-life and elimination pharmacokinetics. In addition, the optimal dose, duration, and route of administration of vitamin K(1) therapy are unknown. We report the case of a 52-year-old man who ingested eight 43-g boxes of a rodenticide (d-Con Mouse-Prufe II; 0.005% brodifacoum; Reckitt & Colman, Wayne, NJ). This case demonstrates that after stabilization with fresh frozen plasma, high-dose oral vitamin K(1) therapy ( congruent with 7 mg/kg per 24 hours divided every 6 hours) was effective in treating brodifacoum-induced coagulopathy. The concentration of vitamin K(1) required for normal coagulation in this case was less than the accepted value of 1 microg/mL, which is derived from a rabbit model. In this case, brodifacoum appears to follow zero-order elimination pharmacokinetics. In future cases of patients with ingestions of long-acting anticoagulants who present with coagulopathy, it may be useful to obtain serial brodifacoum concentrations to determine elimination curves to help predict the duration of oral vitamin K(1) therapy.<p /><p>Language: en</p>",
language="en",
issn="0196-0644",
doi="10.1067/mem.2000.108317",
url="http://dx.doi.org/10.1067/mem.2000.108317"
}