- The labels of all currently US Environmental Protection Agency (EPA) approved indoor rodenticides contain a registration number, active ingredients, concentration, instructions for use, warnings, and first-aid information.
- An accidental ingestion or “taste” by pediatric patients of currently marketed indoor rodenticides, such as the long-acting anticoagulants, bromethalin, cholecalciferol, or zinc phosphide, are not likely to result in serious toxicity.
- Measures such as GI decontamination, prophylaxis with vitamin K1, or laboratory monitoring are unwarranted following accidental tastes of long-acting coagulant rodenticides.
- A single large ingestion or repeated small ingestions of long-acting anticoagulant (“superwarfarin”) compounds may cause serious bleeding. Phytonadione (vitamin K1) is the specific antidote. Active bleeding may require treatment with fresh frozen plasma (FFP).
- Very large ingestions of bromethalin may cause neurologic toxicity attributed to increased intracranial pressure. Cholecalciferol (vitamin D3) may cause hypercalcemia. Zinc phosphide is converted to phosphine gas in the GI tract, and may result in pulmonary edema and multiorgan injury.
- Ingestions of any amount of very old, illegal, or unapproved products for indoor use should be considered extremely serious as these products may contain arsenic, cyanide, strychnine, sodium mono-fluoroacetate, thallium, white phosphorus, aldicarb, or other highly toxic chemicals.
Ingestion of rodenticides by children account for a significant number of exposures reported to poison centers around the country. These exposures are compiled in the National Poison Data System (NPDS) by the American Association of Poison Control Centers (AAPCC). For the 8-year period, 2000 to 2007, NPDS reported a total of 124 127 rodenticide exposures in patients younger than 6 years of age. Trivial, unintentional pediatric ingestions resulted in no clinical effects in the overwhelming majority of cases.
The risk of toxicity following unintentional ingestion of a “taste” or small amount of a rodenticide is determined by its composition and concentration of active ingredients. The EPA currently approves four rodenticides for indoor use: anticoagulants, cholecalciferol, bromethalin, and zinc phosphide. An ingestion of a few granules of these chemicals by a small child is unlikely to cause toxicity (Table 115–1). However, ingestion of even a small quantity of outdated, illegal, or unapproved products designed for indoor use can pose a significant danger to children and pets. Examples of these highly toxic products include strychnine, arsenic, white phosphorus, and sodium mono-fluoroacetate (Table 115–2).
Table 115-1. Other Non-Anticoagulant Indoor Rodenticides |Favorite Table|Download (.pdf)
Table 115-1. Other Non-Anticoagulant Indoor Rodenticides
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Uncouples oxidative phosphorylation resulting in decreased ATP production and increased fluid accumulation which interrupts nerve impulse conduction with resultant increased pressure on nerve axons; there is no established human lethal dose. SX: large ingestions may cause headaches, confusion, tremors, myoclonic jerking, seizure, cerebral edema, or coma. Toxicity may be delayed 8–12 h or longer due to conversion to a more active metabolite...