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COUMARIN INDANDIONES

Examples of Commercial Products and Generic Names

Coumarin (Ratilan, Tomorin)
Diphacinone (Diphasin, Ramik)
Calciferon (Warfarin)
Brodifacoum (Klerat)
Coumate tralyl (Racumin)

Pharmacological Action or Site of Toxicity

Anticoagulant

Routes of Absorption

Ingestion
 Dermal

WHO Hazard Classification

Class 1-III

Symptoms

After repeated ingestion for several days, bleeding from nose, gums and into conjunctive urine and stool.
Possible pallor and petechial rash.

Late- massive ecchymoses or hematoma of skin, joints, brain hemorrhage, (back pain, renal colic and weakness due to hemorrhage)
Shock and death.

Treatment

  1. Lavage stomach with tap water. Catharsis 30 gm, sodium sulfate in 250 ml tap water.
  2. Charcoal suspension should be instilled after gastric lavage.
  3. To restore blood clotting give 10 to 20 mg Vitamin K (Aquamephyton I.V. or Menaphthone Sodium Bisulfite KAPLIN) by oral, intramuscular or intravenous route depending on severity of case. Vitamin C may be a useful adjunct.
  4. Transfuse with fresh blood if bleeding is severe or until anemia is corrected.
  5. Iron (ferrous sulfate) by mouth for correction of secondary anemia 0.3 gm t.i.d.

Treatment of intoxication with anticoagulants should be followed up for several weeks.

Lab Tests

Prothrombin activity of blood plasma, blood in urine and feces.

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Pakistan Agricultural Pesticides Association

909-910, Park Avenue, P.E.C.H.S.,
Shahrah-e-Faisal,
Karachi-75400

Tel:454 1562 Fax:454 6131