Overdose may result from accidental ingestion of rat poison (containing a warfarin-like substance) or overdose of warfarin used for therapeutic purposes.
Warfarin inhibits the production of coagulation factors in the liver.
Clinical features
- Bleeding (can be life threatening) internal or from mucosae
- Usually evident 24 hours after ingestion
Management
- Empty the stomach
- Give activated charcoal 50 g if presenting early
- Child: 25 g (50 g if severe)
- Phytomenadione (vitamin K1) 5 mg IV slowly
- Supportive treatment (IV fluids, blood transfusion, fresh frozen plasma if active bleeding)
Note
- Intoxication with rat poison may require prolonged treatment with vitamin K