Vitamin K: Difference between revisions
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==General== | ==General== | ||
*Lasts up to 2 weeks, possibly making anticoagulation post-bleeding risk difficult | |||
*IV form has small risk of anaphylaxis, but risks/benefits must be weighed in serious bleeding | |||
*Type: Vitamin | |||
*Dosage Forms: 100 mcg; 5mg; SC; IM; IV; PO | |||
*Common Trade Names: Generic and Mephyton, K1-1000, Novaplus Vitamin K1 | |||
==Adult Dosing== | |||
* | ===[[Vitamin K deficiency]] hypoprothrombinemia=== | ||
* | *2.5-25mg PO QD PRN | ||
*Max: 25mg/dose | |||
== | ===[[Anticoagulant]]-induced hypoprothrombinemia=== | ||
*10mg PO x1 | |||
*Max: 25mg/dose | |||
===[[Warfarin]] stabilization=== | |||
*100 mcg PO QD-bid | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Neonatal deficiency (hemorrhagic disease of the newborn)=== | |||
*1mg SC for avoidance of anaphylaxis (IV), hematoma (IM). FFP for serious cases. | |||
===Vitamin K deficiency hypoprothrombinemia=== | |||
*2.5-5mg PO QD PRN | |||
===anticoagulant induced hypoprothrombinemia=== | |||
*0.5-5mg PO/SC/IM/IV x 1 | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Safe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: not defined | ||
**Pediatric | **Pediatric: not defined | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: adjust dose amount | ||
**Pediatric | **Pediatric: adjust dose amount | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*hereditary hypoprothrombinemia | |||
*overanticoagulation due to heparins | |||
*caution in neonates | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*anticoagulant resistance | |||
*hypersensitivity reaction, severe or life-threatening (SC, IM, or IV use) | |||
*anaphylaxis (SC, IM, or IV use) | |||
*hyperbilirubinemia (neonates) | |||
*hemolytic anemia (neonates) | |||
===Common=== | ===Common=== | ||
*taste changes (SC, IM, or IV use) | |||
*flushing (SC, IM, or IV use) | |||
*injection site hematoma | |||
*injection site pain | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: unknown | ||
*Metabolism: | *Metabolism: liver, CYP450: unknown | ||
*Excretion: | *Excretion: urine, bile | ||
*Mechanism of Action: Used by liver for synthesis of some coagulation factors (II,VII,IX,X,C,S). Timing in the synthesis of these factors impacts reversal of elevated INR (~4 hours: F-VII, ~24 hours: F-II). | *Mechanism of Action: Used by liver for synthesis of some coagulation factors (II,VII,IX,X,C,S). Timing in the synthesis of these factors impacts reversal of elevated INR (~4 hours: F-VII, ~24 hours: F-II). | ||
==Comments== | ==Comments== | ||
| Line 43: | Line 73: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:FEN]] | |||
Latest revision as of 23:28, 23 September 2019
Disambiguation: See ketamine for street name "vitamin K"
General
- Lasts up to 2 weeks, possibly making anticoagulation post-bleeding risk difficult
- IV form has small risk of anaphylaxis, but risks/benefits must be weighed in serious bleeding
- Type: Vitamin
- Dosage Forms: 100 mcg; 5mg; SC; IM; IV; PO
- Common Trade Names: Generic and Mephyton, K1-1000, Novaplus Vitamin K1
Adult Dosing
Vitamin K deficiency hypoprothrombinemia
- 2.5-25mg PO QD PRN
- Max: 25mg/dose
Anticoagulant-induced hypoprothrombinemia
- 10mg PO x1
- Max: 25mg/dose
Warfarin stabilization
- 100 mcg PO QD-bid
Pediatric Dosing
Neonatal deficiency (hemorrhagic disease of the newborn)
- 1mg SC for avoidance of anaphylaxis (IV), hematoma (IM). FFP for serious cases.
Vitamin K deficiency hypoprothrombinemia
- 2.5-5mg PO QD PRN
anticoagulant induced hypoprothrombinemia
- 0.5-5mg PO/SC/IM/IV x 1
Special Populations
- Pregnancy Rating: C
- Lactation risk: Safe
- Renal Dosing
- Adult: not defined
- Pediatric: not defined
- Hepatic Dosing
- Adult: adjust dose amount
- Pediatric: adjust dose amount
Contraindications
- Allergy to class/drug
- hereditary hypoprothrombinemia
- overanticoagulation due to heparins
- caution in neonates
Adverse Reactions
Serious
- anticoagulant resistance
- hypersensitivity reaction, severe or life-threatening (SC, IM, or IV use)
- anaphylaxis (SC, IM, or IV use)
- hyperbilirubinemia (neonates)
- hemolytic anemia (neonates)
Common
- taste changes (SC, IM, or IV use)
- flushing (SC, IM, or IV use)
- injection site hematoma
- injection site pain
Pharmacology
- Half-life: unknown
- Metabolism: liver, CYP450: unknown
- Excretion: urine, bile
- Mechanism of Action: Used by liver for synthesis of some coagulation factors (II,VII,IX,X,C,S). Timing in the synthesis of these factors impacts reversal of elevated INR (~4 hours: F-VII, ~24 hours: F-II).