Dose of vitamin Kin case of serious bleeding is ?
Ans. is 'c' i.e., 10 mg Management of warfarin induced bleeding o Phytonadione (vitamin K1) is the preparation of choice because it acts most rapidly. o Management of warfarin induced bleeding is guided by clinical state and INR. Unnecessary high dose is to be avoided because it renders the patient unresponsive to oral anticoagulants for several days. i) INR is < 5 but above therapeutic range -->'Temporarily discontinue warfarin and resta at a lower dose once the INR is within the therapeutic range. ii) IfINR is between 5 to 9 --> Vitamin K1 (phytonadione) at 1-2.5 mg oral. iii) INR is between 9-20 --> Vitamin K1 at 5 mg oral.. iv) If INR is > 20 or serious bleeding Immediate hemostatic competence is necessary. Fresh frozen plasma is transfused immediately supplemented with 10 mg vit K1 intravenous. Fresh frozen plasma replenishes the vit K dependent factor immediately. Alternative to fresh frozen plasma, fresh blood transfusion (supplies clotting factors) or prothrombin complex concentrate (containing factor II, IX and X) can be used. This treatment renders the patient refractory to oral anticoagulants but not to heparin.
2.5 mg
5 mg
10 mg
20 mg