APA
Click to copy
Feinstein, D., Akpa, B., Ayee, M. A., Boullerne, A., Braun, D., Brodsky, S., … Weinberg, G. (2016). The emerging threat of superwarfarins: history, detection, mechanisms, and countermeasures. Annals of the New York Academy of Sciences.
Chicago/Turabian
Click to copy
Feinstein, D., B. Akpa, M. A. Ayee, A. Boullerne, David Braun, S. Brodsky, D. Gidalevitz, et al. “The Emerging Threat of Superwarfarins: History, Detection, Mechanisms, and Countermeasures.” Annals of the New York Academy of Sciences (2016).
MLA
Click to copy
Feinstein, D., et al. “The Emerging Threat of Superwarfarins: History, Detection, Mechanisms, and Countermeasures.” Annals of the New York Academy of Sciences, 2016.
BibTeX Click to copy
@article{d2016a,
title = {The emerging threat of superwarfarins: history, detection, mechanisms, and countermeasures},
year = {2016},
journal = {Annals of the New York Academy of Sciences},
author = {Feinstein, D. and Akpa, B. and Ayee, M. A. and Boullerne, A. and Braun, David and Brodsky, S. and Gidalevitz, D. and Hauck, Zane Z and Kalinin, S. and Kowal, Kathy and Kuzmenko, I. and Lis, K. and Marangoni, N. and Martynowycz, M. and Rubinstein, I. and Breemen, R. and Ware, K. and Weinberg, G.}
}
Superwarfarins were developed following the emergence of warfarin resistance in rodents. Compared to warfarin, superwarfarins have much longer half‐lives and stronger affinity to vitamin K epoxide reductase and therefore can cause death in warfarin‐resistant rodents. By the mid‐1970s, the superwarfarins brodifacoum and difenacoum were the most widely used rodenticides throughout the world. Unfortunately, increased use was accompanied by a rise in accidental poisonings, reaching >16,000 per year in the United States. Risk of exposure has become a concern since large quantities, up to hundreds of kilograms of rodent bait, are applied by aerial dispersion over regions with rodent infestations. Reports of intentional use of superwarfarins in civilian and military scenarios raise the specter of larger incidents or mass casualties. Unlike warfarin overdose, for which 1–2 days of treatment with vitamin K is effective, treatment of superwarfarin poisoning with vitamin K is limited by extremely high cost and can require daily treatment for a year or longer. Furthermore, superwarfarins have actions that are independent of their anticoagulant effects, including both vitamin K–dependent and –independent effects, which are not mitigated by vitamin K therapy. In this review, we summarize superwarfarin development, biology and pathophysiology, their threat as weapons, and possible therapeutic approaches.