Prophylaxis and treatment haemorrhagic disease of the newborn (since vitamin K from the mother may possibly be insufficient due to its poor passage through the placenta and because intestinal bacteria responsible for its natural synthesis are not present for 1st 5-8 days after birth); in the management of overdose of anti-coagulants; in patients with fat mal-absorption (Vitamin K is fat soluble hence it is not absorbed in fat mal-absorption disorders); treatment and prophylaxis of various coagulation disorders due to impaired synthesis of factors II, VII, IX, and X (this may result from vitamin K deficiency, impaired activity of vitamin K eg. hypoprothrombinemia due to coumarin or indanedione-derived oral anticoagulants and other drugs.
Should be based on laboratory tests of clotting functions. See under product below. Dose 2.5 to 10mg, or up to 25mg.
When minor bleeding progresses to major bleeding, administer 5-25 mg [up to 50mg] parenteral vitamin K1. In emergency situations of severe haemorrhage, 200-500 mL of whole blood or fresh frozen plasma or commercial Factor IX complex can be administered.
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It promotes the hepatic synthesis synthesis of clotting factors II, VII, IX, and X. It promotes synthesis of proteins necessary for normal calcification of bones.
It is normally formed by bacteria in the intestine as well as being present in the diet hence its deficiency can arise when there is no bacteria in the gut e.g. in the newborn and in-patients on antibiotics. As it needs bile salts to be absorbed, its absorption is reduced in obstructive jaundice.
Allergy to Vitamin K; liver function impairment. Menadiol may cause hepatotoxicity, hemolytic anemia, and kernicterus in children and is not recommended for use in newborns, especially premature infants. The risk of side effects is lower with phytonadione.
Anaphylaxis; cyanosis; dizziness; transient hypotension; profuse sweating; rapid and weak pulse; hemolytic anemia and liver toxicity especially in children.
||| All vitamin K compounds are 2-methyl-1,4- naphthoquinones. Two natural forms exist: vita- mins K1[phytonadione or phylloquinone] and K2[menaquinone]. Vitamin K1 is found in food. Intestinal bacteria synthesize Vitamin K2 found in human tissues. Menadiol sodium diphosphate [vitamin K4] is a water-soluble derivative con- verted in the body to menadione [vitamin K3].
||| Drug interactions: Coumarin- or indanedione- derived anticoagulants [their concurrent use with vitamin K may reduce their effects due to increased hepatic formation of pro-coagulant factors; antibiotic [due to possible sterilization of the gut]; drugs that reduce their absorption e.g. colestipol, mineral oil and sucralfate.