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{
    "pk": 13463,
    "title": "Severe Vitamin K-dependent Coagulopathy from  Rodenticide-contaminated Synthetic Cannabinoids: Emergency Department Presentations",
    "subtitle": null,
    "abstract": "Introduction:\n Synthetic cannabinoids are a rapidly expanding subset of designer drugs widely available in the United States since 2008. In Illinois during the spring of 2018, over 160 documented cases of bleeding and prolonged coagulopathy occurred secondary to contaminated synthetic cannabinoids.\nMethods:\n We conducted a retrospective cohort study consisting of 38 patients to describe the initial emergency department (ED) presentation, diagnosis, and treatment.\nResults: \nThrough serum testing we found that three long-acting anticoagulant rodenticides (LAAR) were detected in patients who had inhaled these tainted products: brodifacoum, difenacoum, and bromodialone. \nDiscussion:\n This study encompasses the largest ED presentation of LAAR poisoning via the inhalational route known to date. Conclusion: The emergency physician should be aware of the potential for tainted coingestants as the cause of undifferentiated coagulopathy.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Synthetic Cannabinoid, coagulopathy, synthetic marijuana, K2, superwarfarin, brodifacoum"
        }
    ],
    "section": "Toxicology",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5fb5p3dp",
    "frozenauthors": [
        {
            "first_name": "Erik",
            "middle_name": "",
            "last_name": "Wright",
            "name_suffix": "",
            "institution": "University of Illinois College of Medicine Peoria, OSF Saint Francis Medical Center, Department of Emergency Medicine, Peoria, Illinois",
            "department": "None"
        },
        {
            "first_name": "John",
            "middle_name": "W.",
            "last_name": "Hafner",
            "name_suffix": "",
            "institution": "University of Illinois College of Medicine Peoria, Department of Emergency Medicine, Peoria, Illinois",
            "department": "None"
        },
        {
            "first_name": "Gregory",
            "middle_name": "",
            "last_name": "Podolej",
            "name_suffix": "",
            "institution": "University of Illinois Chicago, Jesse Brown VA Medical Center, Department of Anesthesiology, Chicago, Illinois",
            "department": "None"
        },
        {
            "first_name": "Douglas",
            "middle_name": "L.",
            "last_name": "Feinstein",
            "name_suffix": "",
            "institution": "University of Illinois Chicago, Jesse Brown VA Medical Center, Department of Anesthesiology, Chicago, Illinois",
            "department": "None"
        },
        {
            "first_name": "Richard",
            "middle_name": "",
            "last_name": "van Breemen",
            "name_suffix": "",
            "institution": "Oregon State University, Linus Pauling Institute, Department of Pharmaceutical Sciences, Corvallis, Oregon",
            "department": "None"
        },
        {
            "first_name": "Israel",
            "middle_name": "",
            "last_name": "Rubinstein",
            "name_suffix": "",
            "institution": "University of Illinois Chicago, Jesse Brown VA Medical Center, Division of Pulmonary, Critical Care, Sleep, and Allergy Medicine, Chicago, Illinois",
            "department": "None"
        },
        {
            "first_name": "Steven",
            "middle_name": "",
            "last_name": "Aks",
            "name_suffix": "",
            "institution": "Rush University, Department of Emergency Medicine, Chicago, Illinois",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Wahl",
            "name_suffix": "",
            "institution": "John H. Stroger Hospital of Cook County, Department of Emergency Medicine, Chicago, Illinois",
            "department": "None"
        }
    ],
    "date_submitted": "2019-12-29T16:31:11Z",
    "date_accepted": "2019-12-29T16:31:11Z",
    "date_published": "2021-07-15T20:26:55Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13463/galley/7056/download/"
        }
    ]
}