#EMConf: Rodenticides

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


  • 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