About this episode

This episode discusses the recognition, reversal, and prolonged vitamin K therapy for superwarfarin toxicity.

Superwarfarin toxicity: recognition, reversal, and prolonged vitamin K therapy. Hosts: Mac Josh Reandelar, DO Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Superwarfarin_Toxicity.mp3 Download Leave a Comment Tags: Toxicology Show Notes Toxicology & Pathophysiology Long-acting vitamin K antagonists (LA-VKAs), developed as potent rodenticides Examples: brodifacoum, bromadiolone, difenacoum, chlorophacinone Much more potent + far longer acting than warfarin MOA: inhibits VKORC1 → ↓ vitamin K recycling → impaired γ-carboxylation ↓ factors II, VII, IX, X + proteins C/S Highly lipophilic → extensive tissue/fat sequestration + slow redistribution Effect can persist weeks-months ; occasionally much longer Not dialyzable Exposure: large acute ingestion OR repeated low-dose exposure Source may be unclear, concealed, or initially unknown Presentation Often delayed + insidious Severe coagulopathy may precede obvious bleeding Early: epistaxis, gingival bleeding, bruising/ecchymoses, hematuria Classic clue: well-appearing pt + extraordinarily abnormal coagulation studies Severe bleeding: RP hemorrhage, ICH, spinal hemorrhage, tamponade, major GI/GU bleeding RP…

People in this episode

Hosts: Mac Josh Reandelar, DO, Avir Mitra, MD

Topics covered

• Superwarfarin toxicity
• toxicology
• coagulation disorders
• vitamin K therapy
• emergency medicine

Keywords

• superwarfarin
• toxicology
• vitamin K
• coagulation
• emergency medicine
• rodenticides
• bleeding disorders

Mentioned in this episode

Organizations: VKORC1

Products: Superwarfarin, brodifacoum, bromadiolone, difenacoum, chlorophacinone

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