ASK DIS: Indication of Vitamin K in bleeding

Monday, August 15, 2016

Warfarin will acts by inhibiting vitamin K reductase, resulting in depletion of the reduced form of vitamin K. This will increase the risk of bleeding since Vitamin K is needed for coagulation process.
When bleeding occur, vitamin K can be given to reverse the anticoagulant effect of warfarin. It can be given in the injectable formulation or in oral formulation.
Vitamin K is administered based on the INR patient. The doses of Vitamin K as in the table below:

Intravenous Vitamin K should be administered slowly (over at least 30 minutes) to avoid potential anaphylactic reactions.
Subcutaneous and intramuscular administration of Vitamin K should be avoided due to erratic absorption.

In Liver Disease

Vitamin K can be used to treat bleeding that is caused by the liver disease. When liver damage, the synthesis of prothrombin (coagulation factor) will be interrupted. Administration of vitamin K is necessary for the synthesis of prothrombin in the liver.
Moreover in liver disease patient, the amount of bile salt synthesis will be reduced thus it will lead to impaired the absorption of Vitamin K and consequently the amount of Vitamin K will also be reduced in the body.
There is also one study state that the usage of Vitamin K in liver damage patient did not cause a significant improvement in the majority of coagulation parameters and hence does not seem to be routinely indicated in patient with liver disease.

In Long-term usage of Antibiotic

Vitamin K also can be used to treat bleeding that is caused by the antibiotics. There is one study shows that cefoperazone, cefazolin, ceftazidime, cefmetazole, cefpiramide and latamoxef(moxalactam) can prolong prothrombin time in long term of usage, thus if the bleeding occur the usage of vitamin K can be considered for this type of condition.
Besides that, antibiotic can cause bleeding due to vitamin K deficiencies. Antibiotics will destroy not only harmful digestive tract bacteria, but also the beneficial intestinal bacteria that is needed to create vitamin K.

Vitamin K deficiency Bleeding (VKDB)

Vitamin K can be used in the treatment of bleeding in a newborn baby. Newborn babies usually will have deficiency in Vitamin K because only small amounts are passed to them through the placenta from their mothers.
Besides that, the good bacteria that produce vitamin K are not yet present in the newborn’s intestines.
Breast milk will be the only source of Vitamin K in the newborn baby but the amount is not sufficient in order for clotting mechanism to function normally in the body.
Vitamin K is required for the production of clotting factors II, VII, IX and X thus the administration of vitamin K in this kind of patient(bleeding in newborn) will help to improve the production of clotting factors thus normalised the clotting mechanism in the body.

Reference

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