phytonadione, patients, therapy, anticoagulation, INR, dose, warfarin, receiving, thromboembolism, correction, bleeding, adverse reactions, surgery, prothrombin.

intravenously administered phytonadione (vitamin K1) in patients on routine oral warfarin anticoagulation.

ence on Antithrombotic Therapy6 and the British Committee for Standards in Haematology7 recommend phytonadione (vitamin K1) therapy, whereas the American College of Cardiology/American Heart Association suggests avoidance of phytonadione for patients with mechanical heart valves for fear of valve thrombosis.8 In patients who are not bleeding, low-dose phytonadione can return excessive anticoagulation to the therapeutic range.9-12 However, to our knowledge, no published studies have addressed the safety and efficacy of intravenous phytonadione to correct anticoagulation immediately before surgery.

The second patient, a 72-year-old man, had received anticoagulation therapy for severe mitral stenosis and atrial fibrillation and sulfasalazine therapy for chronic ulcerative colitis.

AquaMEPHYTON_PI

http://www.fda.gov/medwatch/SAFETY/2003/03Feb_PI/AquaMEPHYTON_PI.pdf

vitamin, AquaMEPHYTON, administration, phytonadione, prothrombin, injection, anticoagulant, doses, newborn, therapy, prothrombin time, reactions, coagulation, Warning.

Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of AquaMEPHYTON* (Phytonadione).

The majority of these reported events occurred following intravenous administration, even when precautions have been taken to dilute the AquaMEPHYTON and to avoid rapid infusion.

Phytonadione is a vitamin, which is a clear, yellow to amber, viscous, odorless or nearly odorless liquid.

AquaMEPHYTON aqueous colloidal solution of vitamin K1 for parenteral injection, possesses the same type and degree of activity as does naturally-occurring vitamin K, which is necessary for the production via the liver of active prothrombin (factor II), proconvertin (factor VII), plasma thromboplastin component (factor IX), and Stuart factor (factor X).

Chap17

http://www.epa.gov/pesticides/safety/healthcare/handbook/Chap17.pdf

phosphorus, poisoning, ingestion, rodenticides, thallium, vitamin, doses, compounds, dosage, humans, patients, bleeding, symptoms, prothrombin time.

The antiprothrombin effect is best known, and is the basis for detection and assessment of clinical poisoning.

One patient required vitamin K for several months following discharge.6 Another patient was released from the hospital with significant clinical improvement and only slightly elevated coagulation studies after brodifacoum ingestion.

Most authors report the LD50 in humans to be between 10 and 15 mg/kg.10 Unlike other inorganic rodenticides like yellow phosphorus and zinc phosphide, thallium poisoning tends to have a more insidious onset with a wide variety of toxic manifestations.

4. Combined hemodialysis and hemoperfusion has proven moderately effective in reducing the body burden of thallium in victims of severe poisoning.

Brush or scrape non-adherent phosphorus from the skin.