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Case Reports
. 2019 Apr 11;11(4):e4437.
doi: 10.7759/cureus.4437.

Sugar, Spice, and Bleeding

Zainab Shahid  1 , Ricci Kalayanamitra  2 , Maria Hanafi  3 , Khurram Anwar  3 , Rohit Jain  4
Affiliations
Case Reports

Sugar, Spice, and Bleeding

Zainab Shahid et al. Cureus. .

Abstract

Brodifacoum (BDF), otherwise known as superwarfarin, is a long-acting anticoagulant rodenticide (LAAR) which acts as a vitamin K antagonist. Much like warfarin, BDF's mechanism of action is to irreversibly inhibit the enzyme vitamin K epoxide reductase, thus reducing the recycling of vitamin K and, therefore, reducing the activation of clotting factors two, seven, nine, and 10. Although BDF is usually found in rodenticides, it has been recently used as an additive in synthetic cannabinoids. We present a case of a young male with a history of synthetic cannabinoid use who presented with hematuria and epistaxis and was ultimately found to have BDF poisoning.

Keywords: bleeding; brodifacoum; coagulopathy; long-acting anticoagulant rodenticide; superwarfarin; synthetic cannabinoid.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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