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Rodenticides

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Critical Care Toxicology

Abstract

Rodenticides are utilized worldwide. Specific types of rodenticide exposures critical care physicians commonly encounter vary regionally. In the USA, before 1976, anticoagulant rodenticides contained warfarin. However, rodents developed resistance to warfarin, leading to the manufacture of more potent, longer lasting superwarfarins, also known as second-generation anticoagulants or long-acting anticoagulant rodenticides (LAAR). In the USA, the most common rodenticides involved in human poisonings are anticoagulant agents, specifically superwarfarin products. Annual reports of the American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System (TESS) reported ten deaths involving LAAR from 2002 to 2013. Superwarfarins are commonly present in homes throughout the United States, and exposure to them occurs frequently in the pediatric population [1–3]. The amount ingested is usually limited, and coagulopathy from single pediatric ingestions is rare [1–4].

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Author information

Authors and Affiliations

  1. Poison and Drug Information Service (PADIS), Alberta Health Services, Calgary, Alberta, USA

    Ryan Chuang

  2. Department of Emergency Medicine, University of Calgary, Calgary, Alberta, USA

    Ryan Chuang

  3. Staff Physician Denver Health and Hospital Authority Department of Emergency Medicine, Rocky Mountain Poison and Drug Center, Denver, CO, USA

    Jennie A. Buchanan

  4. Division of Medical Toxicology/Department of Emergency Medicine, University of Colorado, Boulder, CO, USA

    Jennie A. Buchanan

Authors
  1. Ryan Chuang
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  2. Jennie A. Buchanan
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Correspondence to Jennie A. Buchanan .

Editor information

Editors and Affiliations

  1. Department of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado, School of Medicine, Aurora, Colorado, USA

    Jeffrey Brent

  2. FDA, Office of New Drugs/Immediate Office, Center for Drug Evaluation and Research, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas’ Hospital, Silver Spring, Maryland, USA

    Paul Dargan

  4. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Benjamin Hatten

  5. Medical Toxicological Intensive Care Unit, Lariboisiere Hospital, Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Robert Palmer

  7. Toxinology Department, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia

    Julian White

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Chuang, R., Buchanan, J.A. (2017). Rodenticides. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_142

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