RESUMO
La intoxicación humana por rodenticidas anticoagulantes de acción prolongada, conocidos como superwarfarinas, provoca coagulopatía de prolongado manejo. Presentamos el caso de un hombre de 42 años que ingirió una dosis tóxica de rodenticida en un intento suicida, evolucionando con epistaxis, INR de 11,6 y necesidad de hospitalización. Durante 7 días se realizaron controles seriados de pruebas de coagulación, con optimización de diferentes dosis de suplementación de Vitamina K. El caso destaca la potencia y vida media prolongada (aproximadamente 6 semanas) de este tipo de anticoagulantes, hecho que requiere un control clínico regular y una adherencia al tratamiento satisfactoria.
Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.
RESUMO
Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.
Assuntos
Anticoagulantes , Rodenticidas , Tentativa de Suicídio , Humanos , Masculino , Adulto , Rodenticidas/intoxicação , Anticoagulantes/intoxicação , 4-Hidroxicumarinas/intoxicação , Vitamina K/uso terapêuticoRESUMO
Dasatinib es un potente inhibidor de la tinosina kinasa utilizado como tratamiento de segunda línea en pacientes con leucemia mieloide crónica, especialmente cuando se desarrolla resistencia o algún tipo de intolerancia a imatinib. A pesar de la aparente selectividad, pueden producirse efectos secundarios significativos. Los derrames pericárdicos son complicaciones frecuentes, que usualmente necesitan reducir la dosis o discontinuar el tratamiento. Por otro lado, la hipertensión pulmonar es un efecto adverso poco frecuente que puede aparecer a los 8 meses del inicio de la terapia. A continuación se presenta el caso de un paciente de 82 años que desarrolla derrame pericárdico crónico e hipertensión pulmonar reversible tras reducción de la dosis de Dasatinib.
Dasatinib is a potent tyrosine kinase inhibitor used as second line treatment for patients with chronic myeloid leukemia, particularly when resistance or some type of intolerance to imatinib has built up. Despite its apparent selectivity it can have significant side effects. Pericardial effusions are frequent complications and usually require dose reduction or treatment discontinuation. On the other hand, pulmonary hypertension is an infrequent side effect which may appear 8 months after initiating treatment. In the following we present the case of an 82 year old who developed a chronic pericardial effusion and pulmonary hypertension which were reversed upon reducing the dasatinib dose.
