The Use of Vitamin K in Patients on Anticoagulant Therapy

@article{Hanslik2004TheUO,
  title={The Use of Vitamin K in Patients on Anticoagulant Therapy},
  author={Thomas Hanslik and Jacques Prinseau},
  journal={American Journal of Cardiovascular Drugs},
  year={2004},
  volume={4},
  pages={43-55}
}
Anticoagulation with antivitamin K (AVK) is very effective for primary and secondary prevention of thromboembolic events. However, questions persist about the risks and management of over-anticoagulation. For reversal of excessive anticoagulation by warfarin, AVK withdrawal, oral or parenteral vitamin K administration, prothrombin complex or fresh frozen plasma may be used, depending on the excess of anticoagulation, the existence and site of active bleeding, patient characteristics and the… 
Effectiveness and safety of a management protocol to correct over-anticoagulation with oral vitamin K: a retrospective study of 1,043 cases
TLDR
This adopted protocol for the reversal of excessive anticoagulation in asymptomatic or minor symptom presenting patients is easily applied, effective in lowering the INR and preventing complications, and in high risk thromboembolic patients warrants caution.
Assessment of Vitamin K Use in the Inpatient Treatment of Excessive Anticoagulation
TLDR
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TLDR
The growing importance of anticoagulant-associated intracerebral hemorrhage is emphasized and options for acute coagulopathy reversal in this setting are described and emphasis is placed on understanding current consensus-based guidelines for coagULopathy reversal and the challenges of determining best evidence for these treatments.
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TLDR
This work has focused on improving the rapid and reliable delivery of a combination of intravenous vitamin K and FFP, with continued re-dosing until the desired INR lowering is achieved.
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TLDR
This case illustrates that Coumadin, a vitamin K agonist, was exerting a therapeutically acceptable negative influence on plasma activity levels of vitamin K-dependent protein C and protein S in a patient with a deep vein thrombosis.
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TLDR
Fresh frozen plasma seems to increase this risk for recurrent VTE patients receiving VKA, and intracranial bleeding and renal insufficiency increased the risk.
Emergency reversal of anticoagulation: from theory to real use of prothrombin complex concentrates. A retrospective Italian experience.
TLDR
In this study three-factor-PCC was found to be effective and safe in rapidly reversing the effects of OAT, although it was not always administered in accordance with international or national guidelines.
Impact of genetic and clinical factors on dose requirements and quality of anticoagulation therapy in Polish patients receiving acenocoumarol: dosing calculation algorithm
TLDR
A dosing calculation algorithm is developed that is, to the best of the knowledge, the first one to assess the effect of such clinical factors as creatinine clearance and dietary vitamin K intake on the AC dose and improves the efficacy and safety of the therapy.
Assessment of the efficacy of a novel tailored vitamin K dosing regimen in lowering the International Normalised Ratio in over‐anticoagulated patients: a randomised clinical trial
TLDR
Individualised vitamin K dosing is more accurate than fixed‐dose regimen in lowering INR to within target range in excessively anticoagulated patients.
Assessment of practice patterns of perioperative management of antiplatelet and anticoagulant therapy in interventional pain management.
TLDR
Clinicians must balance the risks of thromboembolism and bleeding in each patient prior to the routine discontinuation of antiplatelet therapy, as well as adverse events in patients on antithrombotic therapy who undergo interventional pain management techniques when that therapy is continued or stopped.
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