Phytomenadione


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Over-anticoagulation
Adult: 2.5-25 mg. Frequency and amount of subsequent doses are given according to prothrombin time (PT) response or clinical condition.
Elderly: Initiate at the lower end of dosing range.

Oral
Vitamin K deficiency bleeding in neonates
Child: As prophylaxis: 1-2 mg at birth, followed by 2 mg at 4-7 days of age, and a further 2 mg after 1 month of birth.

Parenteral
Vitamin K deficiency bleeding in neonates
Child: As prophylaxis: For healthy neonates: 1 mg via IM inj at birth. For preterm neonates: <2.5 kg: 0.4 mg/kg via IM or IV inj; ≥2.5 kg: 1 mg via IM or IV inj. Dose is given soon after birth. The amount and frequency of further doses are based on coagulation status. As treatment: Initially, 1 mg via SC/IM/IV with or without prothrombin complex concentrate (PCC) or fresh frozen plasma (FFP).

Parenteral
Over-anticoagulation
Adult: For severe cases: 5-10 mg as SC or slow IV inj over at least 30 seconds with PCC or FFP. Max: 40 mg in 24 hours. For patients with INR between 5-9: 0.5-1.0 mg IV. For patients with INR >9: 1.0 mg IV. For purposes of reversal prior to surgery: 5 mg IV.
Elderly: Initiate at the lower end of the dosing range.
Child: For partial reversal: >13 kg: 0.03 mg/kg via IV inj. For complete reversal: >1.6 kg: 0.25-0.30 mg/kg via IV inj.
Cách dùng
May be taken with or without food.
Tương kỵ
IV: Precipitation may occur with Na chloride solution.
Chống chỉ định
Hypersensitivity.
Thận trọng
Patient with mechanical heart valves. Hepatic impairment. Elderly. Children. Pregnancy and lactation.
Tác dụng không mong muốn
Cardiac disorders: Dyspnoea.
Gastrointestinal disorders: Taste disturbance.
Injury, poisoning and procedural complications: Irritation, phlebitis, schleroderma-like lesions; erythematous, indurated, and pruritic plaques (repeated inj).
Investigations: Rapid or weak pulse.
Nervous system disorders: Dizziness.
Skin and subcutaneous tissue disorders: Sweating.
Vascular disorders: Hypotension, cyanosis, flushing.
Potentially Fatal: Rarely, anaphylactoid reactions (IM/IV).
IM/IV/Parenteral/SC: C
Chỉ số theo dõi
Regularly monitor PT, INR and vitamin K dependent clotting factors; hypersensitivity reactions.
Tương tác
Antagonises the effect of coumarin anticoagulants.
Tác dụng
Description:
Mechanism of Action: Phytomenadione (vitamin K1), a naturally occurring compound, promotes hepatic synthesis of clotting factors (II, VII, IX, X) and of coagulation inhibitors (protein C and S). It is used to prevent and treat haemorrhages related to vitamin K deficiency.
Pharmacokinetics:
Absorption: Absorbed from the gastrointestinal tract in the presence of bile salts. Readily absorbed via IM inj.
Distribution: Accumulates in the liver and stored in the body for short periods of time. Plasma protein binding: Up to 90%, to lipoproteins.
Metabolism: Rapidly metabolised in the liver into polar metabolites (e.g. phytomenadione-2,3-epoxide).
Excretion: Via urine and faeces (as glucuronide and sulfate conjugates). Plasma elimination half-life: 2-3 hours.
Đặc tính

Chemical Structure Image
Phytomenadione

Source: National Center for Biotechnology Information. PubChem Database. Vitamin K1, CID=5284607, https://pubchem.ncbi.nlm.nih.gov/compound/Vitamin-K1 (accessed on Jan. 22, 2020)

Bảo quản
Store between 20-25°C. Protect from light.
Phân loại MIMS
Thuốc cầm máu
Phân loại ATC
B02BA01 - phytomenadione ; Belongs to the class of vitamin K. Used in the treatment of hemorrhage.
Tài liệu tham khảo
Anon. Phytonadione. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/11/2017.

Aquamephyton Injection, Emulsion (Teligent Pharma, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2017.

Buckingham R (ed). Vitamin K Substances. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2017.

Joint Formulary Committee. Phytomenadione. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Phytonadione. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 07/11/2017.

Mephyton Tablet (Carilion Materials Management). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2017.

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