Zupancić-Salek Silva, Kovacević-Metelko Jasminka, Radman Ivo
Haemophilia Centre, Department of Haematology, University Hospital Rebro, Kispatic str. 12, 10000 Zagreb, Croatia.
Blood Coagul Fibrinolysis. 2005 Jun;16(4):239-44. doi: 10.1097/01.mbc.0000169215.70184.56.
The use of second-generation anticoagulants termed "superwarfarins" as rodenticides, although widespread, is poorly controlled. Products containing superwarfarin have been marketed in over-the-counter rodenticides and can be easily purchased. Poor control potentiates the risk of accidental or intentional poisoning, but clinicians may underestimate the incidence of superwarfarin toxicity. Therefore, when cases of unexplained acquired coagulopathy and selective deficiency of vitamin K-dependent clotting factors occur in patients in the absence of liver disease or inhibitors, physicians should consider the possibility of superwarfarin poisoning as a cause. According to our own experience, recombinant activated factor VII (NovoSeven; Novo Nordisk, Bagsvaerd, Denmark) appears to be a safe and effective therapy for acute bleeding caused by superwarfarin poisoning. Due to the extended half-life of the second-generation rodenticides, follow-up therapy with oral vitamin K1 should be of long-term duration.
使用被称为“超级华法林”的第二代抗凝血剂作为灭鼠剂的情况虽然普遍，但管控不力。含有超级华法林的产品已在非处方灭鼠剂中销售，且很容易买到。管控不力增加了意外或故意中毒的风险，但临床医生可能会低估超级华法林中毒的发生率。因此，当患者在没有肝病或抑制剂的情况下出现无法解释的获得性凝血病和维生素K依赖凝血因子选择性缺乏的病例时，医生应考虑超级华法林中毒作为病因的可能性。根据我们自己的经验，重组活化因子VII（诺其；丹麦诺和诺德公司， Bagsvaerd）似乎是治疗超级华法林中毒所致急性出血的一种安全有效的疗法。由于第二代灭鼠剂的半衰期延长，口服维生素K1的后续治疗应持续较长时间。
