Anticoagulant rodenticide poisoning

Anticoagulant rodenticides are one of the common household pesticides which may be consumed intentionally or unintentionally by human subjects. The diagnosis of poisoning may be missed without a suggested history. The bleeding episodes may be delayed by days to weeks after an exposure to anticoagulant rodenticides. The second generation rodenticides (LAARs) may lead to ‘rebound coagulopathy’ which is highly suggestive of a possible diagnosis of poisoning. The definitive diagnosis of rodenticide poisoning may be made by utilizing HPLC to determine serum levels of specific anticoagulant levels. Patients are triaged and observed along with periodic assessment of coagulopathy. Bleeding patients require acute interventions followed by long term administration of vitamin K1 to manage rebound coagulopathy.