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December 7, 1984

Human Ingestion of a 'Superwarfarin' Rodenticide Resulting in a Prolonged Anticoagulant Effect

Author Affiliations

From the Hemophilia Treatment Program (Dr Lipton) and the Department of Medicine (Drs Lipton and Klass), State University of New York at Stony Brook and Long Island Jewish—Hillside Medical Center, New Hyde Park, NY.

JAMA. 1984;252(21):3004-3005. doi:10.1001/jama.1984.03350210052030

IN THE past decade, several novel hydroxycoumarin anticoagulants have been developed as rodenticides. These so-called superwarfarins have been developed to deal with the serious public health problem of warfarin resistance in rodents. This genetically determined resistance appears rapidly in wild rats and mice because it is transmitted as a dominant trait.

Report of a Case  A 31-year-old woman with a long history of mental illness and many hospitalizations for acute psychoses ingested over a two-day period approximately thirty 50-g packages of a commercial rodenticide (Talon-G) that contains brodifacoum. She purchased the rodenticide in a hardware store. On April 18,1983, five days after the ingestion, her family had her admitted to the hospital's psychiatric unit, and she was seen in medical consultation.Her BP was 120/70 mm Hg; pulse rate, 78 beats per minute; and respirations, 18/min. There were no orthostatic changes in the vital signs. There were multiple superficial slash