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Any Substance that is used to kill rats, mice and other rodent pests.
 In India and in many parts of the world, huge quantity of grains is eaten up and
destroyed by rats.
 Hence for preservation of grains use of rodenticidal agents has become
imperative.
 Single feed baits are chemicals ,sufficiently dangerous enough to kill the rats at
its first dose.
 Rodenticides are controversial due to secondary poisoning due to their risk to
humans and pets.
 These rat poisons have recently become a common means
of self poisoning in Northern India , with a mortality rate
of 60%.
 Poisoning may be:
-Suicidal
-Accidental
-Homicidal
 Modes of poisoning:
-Ingestion
-Inhalation
-Dermal contact
INGESTION
INHALATION
DERMAL CONTACT
 Inorganic preparations:
Barium carbonate, phosphorous ,Thallium , Zn phosphide
 Organic preparations:
Flouro acetate compounds
 Convulsants:
Strychnine
 Anti coagulants:
-First generation : warfarin , coumatetrayl
-Second generation : Brodifacoum , Difenacoum
 Others: Arsenic , Bromethalin , Endrin , Sodium fluoro acetate
and Zyklon.
 Zinc phosphide:
- It is a single dose fast acting rodenticide.
-Death occurs with in 1-3days after ingestion.
-MOA:
Acid in the stomach reacts with the phosphide to yield toxic
phosphine gas which is a potent pulmonary toxicant.
 Calciferols:
-MOA:
On ingestion in toxic doses these affect calcium and
phosphate homeostasis causing hypercalcemia.
-On accumulation in stomach , kidney , lungs , blood vessels and
heart are all calcified/mineralised.
-It has a synergistic effect with anticoagulant , thereby increasing
the chances of death and decrease in the time involved.
 ANTI COAGULANTS:
-After ingestion of lethal dose , it effectively blocks the vit-k
cycle , resulting in inability to produce essential blood clotting
factors mainly factors II and VII.
- massive toxic doses of 4-hydroxycoumarin cause
damage to tiny blood vessels , increasing their
permeability , causing diffuse Internal Bleeding.
-These effects are gradual , developing over several days.
-This is the preferred type of rat bait , as the antidote is
available i.e, Vit-K.
 WITH ZINC PHOSPHIDE:
-Via Inhalation : Cough, Nausea ,Vomiting,Headache
Fatigue.
-Via Ingestion: Abdominal pain , Cough , Diarrhoea ,
Dizziness , Shortness of breath ,
Unconsciousness , Nausea , Vomiting
Uncoordinated movements.
 Nausea , Vomiting , Anorexia , Fatigue , Itching and
Weakness.
 Acute Intoxication: Polyneuropathy.
 Chronic Intoxication: Extreme depression , Apathy ,
Confusion , Fatigue.
 Do not have onset symptoms , which might manifest days
later.
 Haematuria
 Bloody diarrhoea
 Extensive Bruising
 Epistaxis
 Haematemesis
 Low Blood pressure
 Confusion , Lethargy , Altered mental status
 Shock
 With Warfarin: Pin point Purplish red spots
 WITH BARIUM: Nausea , Weakness , Abdominal pain.
 WITH THALLIUM: Acute GI distress , Anorexia ,
Myalgias , Painful neuropathy and
hair loss.
 WITH STRYCHNINE: Anxiety , Generalized seizure like
appearance without loss of
consciousness , Muscle twitching ,
Facial grimacing.
 WITH ARSENIC: Nausea , Vomiting , Bloody diarrhoea
and garlic taste in mouth.
 APPROACH CONSIDERATIONS:
• Complete blood count
• PT
• INR
• Activated PTT
• BT
• Platelet count
• Lab verification of Brodifacoum , Difenacoum.
• CPK
• LA
• Blood test for arsenic & Thallium
• Abdominal Plain Film Radiography
• Detecting phosphine in exhaled air/stomach aspirate using
either a silver nitrate impregnated strip or specific
phosphine detector tube is diagnostic.
• But Gas chromatography provides the most sensitive
indicator.
 Always look for a container , so that the specific
product can be determined.
 Decontamination may be necessary.
 Secure airway and place IV lines in Haemodynamically unstable
patients.
 ACTIVATED CHARCOAL is used as soon as possible to prevent
further systemic absorption of ingested toxin.
 GI EVACUATION in cases of huge over dosage and in which the
patient presents early to an emergency facility.
 Inducing Vomiting is likely only with in 1-2hrs
after ingestion.
 ZINC PHOSPHIDE:
-Supportive therapy remains the only available form as there is no
specific antidote.
-Gastric lavage with vegetable oil to
reduce the release of toxic phosphine.
-Patients with severe respiratory
compromise require endotracheal
intubation for ventilatory support.
-Severe haemolysis from phosphine gas may require exchange
transfusion of RBCs.
 If no coagulopathy is found in the setting of an anti-
coagulant exposure ,prophylactic treatment with Vit-K is
absolutely contraindicated.
 If a coagulopathy is documented , Vit-K therapy is
suggested.
 Patients who present with life threatening haemorrhage ,
in addition to Vit-K, Prothrombin complex conc. and/or
fresh frozen plasma may be needed to reverse anti
coagulation.
Rat poisoning management

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Rat poisoning management

  • 1.
  • 2. Any Substance that is used to kill rats, mice and other rodent pests.  In India and in many parts of the world, huge quantity of grains is eaten up and destroyed by rats.  Hence for preservation of grains use of rodenticidal agents has become imperative.  Single feed baits are chemicals ,sufficiently dangerous enough to kill the rats at its first dose.  Rodenticides are controversial due to secondary poisoning due to their risk to humans and pets.
  • 3.  These rat poisons have recently become a common means of self poisoning in Northern India , with a mortality rate of 60%.  Poisoning may be: -Suicidal -Accidental -Homicidal  Modes of poisoning: -Ingestion -Inhalation -Dermal contact
  • 5.  Inorganic preparations: Barium carbonate, phosphorous ,Thallium , Zn phosphide  Organic preparations: Flouro acetate compounds  Convulsants: Strychnine  Anti coagulants: -First generation : warfarin , coumatetrayl -Second generation : Brodifacoum , Difenacoum  Others: Arsenic , Bromethalin , Endrin , Sodium fluoro acetate and Zyklon.
  • 6.  Zinc phosphide: - It is a single dose fast acting rodenticide. -Death occurs with in 1-3days after ingestion. -MOA: Acid in the stomach reacts with the phosphide to yield toxic phosphine gas which is a potent pulmonary toxicant.  Calciferols: -MOA: On ingestion in toxic doses these affect calcium and phosphate homeostasis causing hypercalcemia.
  • 7. -On accumulation in stomach , kidney , lungs , blood vessels and heart are all calcified/mineralised. -It has a synergistic effect with anticoagulant , thereby increasing the chances of death and decrease in the time involved.  ANTI COAGULANTS: -After ingestion of lethal dose , it effectively blocks the vit-k cycle , resulting in inability to produce essential blood clotting factors mainly factors II and VII.
  • 8. - massive toxic doses of 4-hydroxycoumarin cause damage to tiny blood vessels , increasing their permeability , causing diffuse Internal Bleeding. -These effects are gradual , developing over several days. -This is the preferred type of rat bait , as the antidote is available i.e, Vit-K.
  • 9.  WITH ZINC PHOSPHIDE: -Via Inhalation : Cough, Nausea ,Vomiting,Headache Fatigue. -Via Ingestion: Abdominal pain , Cough , Diarrhoea , Dizziness , Shortness of breath , Unconsciousness , Nausea , Vomiting Uncoordinated movements.
  • 10.  Nausea , Vomiting , Anorexia , Fatigue , Itching and Weakness.  Acute Intoxication: Polyneuropathy.  Chronic Intoxication: Extreme depression , Apathy , Confusion , Fatigue.
  • 11.  Do not have onset symptoms , which might manifest days later.  Haematuria  Bloody diarrhoea  Extensive Bruising  Epistaxis  Haematemesis  Low Blood pressure  Confusion , Lethargy , Altered mental status  Shock  With Warfarin: Pin point Purplish red spots
  • 12.  WITH BARIUM: Nausea , Weakness , Abdominal pain.  WITH THALLIUM: Acute GI distress , Anorexia , Myalgias , Painful neuropathy and hair loss.  WITH STRYCHNINE: Anxiety , Generalized seizure like appearance without loss of consciousness , Muscle twitching , Facial grimacing.  WITH ARSENIC: Nausea , Vomiting , Bloody diarrhoea and garlic taste in mouth.
  • 13.  APPROACH CONSIDERATIONS: • Complete blood count • PT • INR • Activated PTT • BT • Platelet count • Lab verification of Brodifacoum , Difenacoum. • CPK • LA • Blood test for arsenic & Thallium
  • 14. • Abdominal Plain Film Radiography • Detecting phosphine in exhaled air/stomach aspirate using either a silver nitrate impregnated strip or specific phosphine detector tube is diagnostic. • But Gas chromatography provides the most sensitive indicator.
  • 15.  Always look for a container , so that the specific product can be determined.  Decontamination may be necessary.
  • 16.  Secure airway and place IV lines in Haemodynamically unstable patients.  ACTIVATED CHARCOAL is used as soon as possible to prevent further systemic absorption of ingested toxin.  GI EVACUATION in cases of huge over dosage and in which the patient presents early to an emergency facility.  Inducing Vomiting is likely only with in 1-2hrs after ingestion.
  • 17.  ZINC PHOSPHIDE: -Supportive therapy remains the only available form as there is no specific antidote. -Gastric lavage with vegetable oil to reduce the release of toxic phosphine. -Patients with severe respiratory compromise require endotracheal intubation for ventilatory support. -Severe haemolysis from phosphine gas may require exchange transfusion of RBCs.
  • 18.  If no coagulopathy is found in the setting of an anti- coagulant exposure ,prophylactic treatment with Vit-K is absolutely contraindicated.  If a coagulopathy is documented , Vit-K therapy is suggested.  Patients who present with life threatening haemorrhage , in addition to Vit-K, Prothrombin complex conc. and/or fresh frozen plasma may be needed to reverse anti coagulation.