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Superwarfarins (vitamin K super antagonist rodenticides)

III.c Hemoptysis

Superwarfarins in cannabinoid samples can cause severe bleeding diathesis (See: Kelkar, A.H. et al. An Outbreak of Synthetic Cannabinoid–Associated Coagulopathy in Illinois. N Engl J Med, 2018. 379: 1216-23

Last update : 30/09/2018

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

Superwarfarins (vitamin K super antagonist rodenticides)

III.c Hemoptysis

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