#EMConf: Rodenticides
Thu, 03/28/2019 - 11:45am
Editor:
The mnemonic is BRATS PANIC
- Bromethalin
- Red Squill: Digoxin-like for rats
- Arsenic: antidote is succimer or dimercaprolBAL)
- Thallium
- Strychnine or SMFA
- Strychnine blocks Glycine (Inhibitory neurotransmitter) and can lead to twitching but awake aka "awake seizure"
- PNU (Vacor) or Phosphorous
- PNU: beta-islet poison for rats
- Phosphorous: leads to smoking white stools
- ANTU
- Norbormide
- Indandiones: superwarfarin
- Coumarins: superwarfarin
- Cholecalciferol: unlikely to cause toxicity in humans but leads to significant hypocalcemia in rats
Management
- if single ingestion and asymptomatic, likely discharge unless a candidate for activated charcoal
- will need PCP follow up in two days for INR check
- Vitamin K only if INR is elevated
- no role for prophylactic vitamin K