Phytomenadione or menadiol in the management of an elevated international normalized ratio (prothrombin time)

Green, B., Cairns, S., Harvey, R. and Pettit, M. (2000) Phytomenadione or menadiol in the management of an elevated international normalized ratio (prothrombin time). Alimentary Pharmacology & Therapeutics, 14 12: 1685-1689. doi:10.1046/j.1365-2036.2000.00880.x


Author Green, B.
Cairns, S.
Harvey, R.
Pettit, M.
Title Phytomenadione or menadiol in the management of an elevated international normalized ratio (prothrombin time)
Journal name Alimentary Pharmacology & Therapeutics   Check publisher's open access policy
ISSN 0269-2813
1365-2036
Publication date 2000-01-01
Sub-type Article (original research)
DOI 10.1046/j.1365-2036.2000.00880.x
Volume 14
Issue 12
Start page 1685
End page 1689
Total pages 5
Place of publication Oxford, England
Publisher Blackwell Science
Language eng
Subject CX
320503 Clinical Pharmacology and Therapeutics
730102 Immune system and allergy
Formatted abstract
Aim:
To evaluate the efficacy of oral menadiol compared to intravenous phytomenadione when correcting coagulopathies associated with cholestasis.

Methods:
A total of 26 patients with cholestasis and an international normalized ratio (prothrombin time) greater than 1.2, were randomized to receive either 20 mg o.d. for 3 days of oral menadiol (n=12), or 10 mg o.d. of intravenous phytomenadione (n=14) prior to endoscopic retrograde cholangeopancreatography. Liver function tests and international normalized ratio were measured daily for 3 days.

Results:
Liver function tests and international normalized ratio were comparable between groups at entry into the study (P > 0.05), but serum albumin was significantly lower in the intravenous phytomenadione group following treatment (P < 0.05). A decrease in international normalized ratio occurred in both groups following administration of vitamin K (P < 0.05). Two patients in the intravenous group required fresh frozen plasma, as failure to normalize international normalized ratio was observed. No adverse drug reactions were observed in either group, and no patient required re-admission for bleeding during a 4-week follow-up period after cholangeopancreatography.

Conclusion:
Oral menadiol appears to be an effective alternative to intravenous phytomenadione in the correction of coagulopathies associated with obstructive liver disease. This simplifies the care of patients with deranged clotting times requiring cholangeopancreatography, particularly those to be managed as out-patients.
Keyword Gastroenterology & Hepatology
Pharmacology & Pharmacy
Performance Liquid-chromatography
Primary Biliary-cirrhosis
Vitamin-k
Plasma
Q-Index Code CX

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Pharmacy Publications
 
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Created: Tue, 10 Jun 2008, 21:48:53 EST