Emergency Medical Minute Podcast #324: Superwarfarin
May 2, 2018
04:03
Author: Rachel Beham, PharmD
Educational Pearls:
- Some synthetic cannabinoids have been contaminated with Brodifacoum. Brodifacoum is a Vitamin K antagonist and can present with a severe coagulopathy.
- Brodifacoum is commonly known as "superwarfarin" and has a very long half life of 120+ days.
- Check PT/INR in patients with a bleeding diathesis in setting of synthetic cannabinoid use.
- Treatment is activated charcoal and large doses of Vitamin K (10mg Q6H for months).
References:
Lipton R.A.; Klass E.M. (1984). "Human ingestion of a 'superwarfarin' rodenticide resulting in a prolonged anticoagulant effect". JAMA. 252: 3004–3005.
La Rosa F; Clarke S; Lefkowitz J. B. (1997). "Brodifacoum intoxication with marijuana smoking". Archives of Pathology & Laboratory Medicine. 121: 67–69