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Medication

Medication Summary

In vitamin K (VK) deficiency, the goals of pharmacotherapy are to correct the deficiency, reduce morbidity, and prevent complications. Newborns commonly are given VK-1 injections intramuscularly to prevent bleeding problems. In adults, VK-1 should be administered subcutaneously or intramuscularly. If the PT does not normalize, good evidence exists for the presence of liver disease or DIC. Vitamin K is necessary for the function of clotting factors in the coagulation cascade.^{[3, 4, 36]}

Some small studies have suggested that prophylaxis with VK in newborn patients may increase the risk of cancer, but large, observational trials have found no such correlation.^[30]

Another observational study (Nurse's Health Study) found that a higher dietary intake of VK is associated with a significantly reduced risk of hip fracture. In Japan, high oral doses of VK (45mg/day) are given to prevent osteoporosis with little known side effects.^[19]

Class Summary

These are used to supplement existing levels of essential vitamins or to replace essential vitamins that are not obtained in sufficient quantities in the diet. Vitamin K is necessary for the function of clotting factors in the coagulation cascade.

Phytonadione (Mephyton)

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Phytonadione promotes the synthesis of clotting factors in the liver. The oral form requires the presence of bile in the small intestine for absorption and is therefore not used in emergency situations. Metabolism occurs in the liver, and elimination occurs in bile and urine. Phytonadione has a more rapid and prolonged effect than does menadione (water soluble). The injectable form should be protected from light at all times (it may be autoclaved).

Class Summary

Plasma is the fluid compartment of blood containing the soluble clotting factors.

Fresh frozen plasma

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Fresh frozen plasma is for use in patients with blood product deficiencies.

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Author

Dieu-Thu Nguyen-Khoa, MD, FACP Associate Clinical Professor of Medicine, University of California, Los Angeles, David Geffen School of Medicine; Physician Specialist, Department of Primary Care and Community Medicine, ValleyCare Olive View-UCLA Medical Center

Dieu-Thu Nguyen-Khoa, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Pankaj Patel, MD Fellow, Department of Gastroenterology, Winthrop University Hospital and The School of Medicine at Stony Brook University Medical Center

Pankaj Patel, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians-American Society of Internal Medicine

Disclosure: Nothing to disclose.

Mageda Mikhail, MD Assistant Professor, Department of Medicine, Division of Endocrinology, The School of Medicine at Stony Brook University Medical Center

Mageda Mikhail, MD is a member of the following medical societies: Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for Physician Leadership, American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society, International Society for Clinical Densitometry, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Hampton Roy, Sr, MD † Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgements

Romesh Khardori, MD, PhD, FACP Professor of Endocrinology, Director of Training Program, Division of Endocrinology, Diabetes and Metabolism, Strelitz Diabetes and Endocrine Disorders Institute, Department of Internal Medicine, Eastern Virginia Medical School

Romesh Khardori, MD, PhD, FACP is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Vitamin K Deficiency Medication

Medication Summary

Vitamins, Fat-Soluble

Class Summary

Phytonadione (Mephyton)

Phytonadione (Mephyton)

Blood Components

Class Summary

Fresh frozen plasma

Fresh frozen plasma

Vitamin K Deficiency Medication

Medication Summary

Vitamins, Fat-Soluble

Class Summary

Phytonadione (Mephyton)

Phytonadione (Mephyton)

Blood Components

Class Summary

Fresh frozen plasma

Fresh frozen plasma

References

Tables

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