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Vitamin K1 (Phytonadione)

Viking (K) King with (1) Wand
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Vitamin K1 is an essential component in the synthesis of prothrombin and clotting factors II, VII, IX, and X, which allow the blood to coagulate. When there is an inadequate supply of vitamin K in the body, clotting factors are not readily synthesized, which can lead to spontaneous bleeding. Vitamin K1 is indicated in the treatment of hypoprothrombinemia, warfarin overdose, and prophylaxis of hemorrhage in newborns. Side effects are serious and can include bilirubin-induced brain dysfunction (kernicterus), and hypersensitivity reactions such as shock and cardiac arrest. To prevent a potentially life-threatening hypersensitivity reaction, vitamin K1 should not be given intravenously unless other routes of administration are contraindicated.
9 KEY FACTS
MECHANISM
Synthesizes Clotting Factors II, VII, IX, X
Making Clogs at Factory for (2) Tutu, Lucky (7), (9) Lives cat, and (10) Tin

Vitamin K1 is essential in the synthesis of prothrombin and clotting factors II, VII, IX, and X, which allow the blood to coagulate. When there is an inadequate supply of vitamin K in the body, clotting factors are not readily synthesized, which can lead to spontaneous bleeding.

INDICATIONS
Hypoprothrombinemia
Hippo-pro with Hourglass

Prothrombin is a precursor to thrombin, which is an element of the clotting cascade that is needed to convert fibrinogen to fibrin. Because prothrombin is necessary for clotting to occur, patients with hypoprothrombinemia are prone to bleeding. In these patients, vitamin K1 is given to increase synthesis of prothrombin. 

Newborn Prophylaxis
Newborn with Purple-axes

Babies are born with a vitamin K deficiency. In order to prevent complications such as hemorrhage, newborns are given a single dose of vitamin K1 to increase prothrombin levels and to prevent bleeding.

Bleeding from Warfarin Overdose
Bleeding War-fairy Overdosing

Warfarin is a vitamin K antagonist and can cause bleeding or hemorrhage when the therapeutic dose is exceeded.

SIDE EFFECTS
Shock
Shocked

When administered intravenously, vitamin K1 can elicit a hypersensitivity reaction, leading to shock and possible death.

Kernicterus
Colonel

Administration of parenteral vitamin K can cause serum bilirubin levels to rise in newborns, especially those born prematurely. Bilirubin is a neurotoxic substance and can cause bilirubin-induced brain dysfunction known as kernicterus.

Cardiac Arrest
Heart being Arrested

Patients who receive vitamin K1 intravenously are at an increased risk of cardiac arrest. To prevent a potentially life-threatening hypersensitivity reaction, vitamin K1 should not be administered intravenously unless absolutely necessary.

CONSIDERATIONS
Bile Salts required for Intestinal Absorption
Bile-Nile Salt-shaker with Absorbing-sponge at Intestines

Adequate intestinal absorption of vitamin K1 is dependent upon the presence of bile salts.

Increased Risks with IV Administration
Up-arrow Risk at IV-stand

Intravenous administration of vitamin K1 can cause life-threatening hypersensitivity reactions including shock and cardiac arrest. For this reason, vitamin K1 should not be given intravenously unless other routes of administration are contraindicated. 

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