A 55-year-old man came to the hospital with a bleeding wound on his tongue. The coating of his tongue was green, and his sputum was red. Because an increased international normalized ratio-value was measured, a blood sample was sent to our laboratory with the suspicion of coumarin intoxication. Liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS) analysis confirmed the poisoning was by bromadiolone, with its maximum serum concentration at 440 microg/L. The analysis of further samples resulted in a calculated elimination half-life of 140 h. The analytical method described was developed for the determination and quantitation of bromadialone using LC-MS. This method is suitable for the simultaneous identification and quantitation of 10 indirect anticoagulants in human serum, which include five superwarfarins (brodifacoum, bromadiolone, difenacoum, difethialone, and flocoumafen) as rodenticides licenced in Germany and five other vitamin K antagonists (acenocoumarol, coumatetralyl, coumachlor, phenprocoumon, and warfarin). The method is based on an acidic (pH 4.2) liquid-liquid extraction followed by LC-ESI-MS analysis. Analytical separation was carried out using an Atlantis C18 column (2.1 x 20 mm, 3 microm). The mobile phase consisted of methanol/0.1% formic acid; the flow rate was 0.6 mL/min, and the time needed for analysis was 5 min. The lower limit of quantitation was 5 microg/L (signal-to-noise > 10).
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机译：一名55岁的男子因伤口流血来到医院。他的舌头是绿色的，痰是红色的。因为测量到的国际标准化比率值增加了，所以血液样本被怀疑带有香豆素中毒而被送往我们的实验室。液相色谱-电喷雾电离质谱（LC-ESI-MS）分析证实中毒是由溴苯丙隆引起的，其最大血清浓度为440微克/升。进一步分析样品得出的消除半衰期为140小时。开发了上述分析方法，用于使用LC-MS测定和定量溴代马隆酮。该方法适用于同时鉴定和定量人类血清中的10种间接抗凝剂，其中包括5种在德国获得许可的杀鼠剂的超级华法林（溴地美，溴丙二醇酮，地非那定，地非噻酮和氟可马芬）和其他五种维生素K拮抗剂（乙酰香豆酚，香茅醛，香豆氯，苯丙香酚和华法林）。该方法基于酸性（pH 4.2）液-液萃取，然后进行LC-ESI-MS分析。使用Atlantis C18色谱柱（2.1 x 20 mm，3微米）进行分析分离。流动相由甲醇/0.1%甲酸组成;流速为0.6 mL / min，分析所需时间为5 min。定量下限为5微克/升（信噪比> 10）。
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