Vit K1 Task 5

Drug Study (I) (Skidmore-Roth, 2012)

Vitamin K

Generic Name- phytonadione (vit K1)

Trade Name- mephyton

Functional Class- Vit K1, fat- soluble vitamin

Action

Needed for adequate blood clotting (factors II, VII, IX, X)

Uses

Vit K malabsorption, hypoprothrombinemia, prevention of hypoprothrombinemia caused by oral anticoagulants, prevention of hemorrhagic disease of the newborn

Dosage and routes

Prevention of hemorrhagic disease of the newborn

Neonate: IM 0.5-1 mg within 1 hour after birth, repeat in 2-3 week if required.

Hypoprothrombinemia caused by vit K malabsorption

Adult: PO/IM 2.5-25 mg, may repeat or increased to 50 mg, Child: PO/IM 5-10 mg, Infant: PO/IM 2mg.

Hypoprothrombinemia caused by oral anticoagulants

Adult and child: PO/SC/IM

Assess for prothrombin time during treatment (2 sec deviation from control time, bleeding time, and clotting time); monitor for bleeding, pulse, and BP. Assess for nutritional status: liver (beef), spinach, tomatoes, coffee, asparagus, broccoli, cabbage, lettuce, greens. Administer IV route after diluting with D5, NS 10 ml or more give 1 mg/min or more. IV route only when other routes not possible (deaths have occurred).

Perform/provide

Store in tight, light-resistant container

Evaluate

Therapeutic responses: decreased bleeding tendencies, decreased PT, decreased clotting time.

Teach patient/ family

Not to take other supplements unless directed by prescriber. The necessary foods for diet. To avoid IM inj, use soft tooth-brush, do not floss, use electronic razor until coagulating defects corrected. To report symptoms of bleeding. Not to use OTC medications unless approved by prescriber. The importance of frequent lab tests to monitor coagulation factors.

3.2. Drug Study (II)

Hepatitis B vaccine (Karc, 2006)

Generic Name- Hepatitis B vaccine

Trade Name- Engerix-B, Recombivax HB

Therapeutic Actions

Provide inactivated human hepatitis B surface antigen particles to stimulate active immunity and production of antibodies against hepatitis B surface antigen produced by

Dosage

Birth-10 years: Initial dose- 0.5 ml, followed by 0.5 ml IM at 1 month and 6 month after initial dose. 11-19 yrs: 0.5 ml followed by 0.5 ml IM at 1 month and 6 month after initial dose. Adult: 1 ml followed by 1 ml IM at 1 month and 6 month after initial dose, all types. Revaccination: a booster dose should be considered if anti-HBs levels < 10mlU/ml 1 to 2 month after third dose. Children < 10 yrs: 10mcg, Adults and patients > 10 yrs > 20mcg.

Nursing considerations

Do not administer to any patient with known hypersensitivity to any component of the vaccine or allergy to yeast. Use caution in pregnant woman or nursing woman. Pregnancy category C safety not established. Use only if clearly needed and benefits outweigh potential unknown effects. Use caution in patients with active infection. Delay use of vaccine if possible. Use with caution in any patient with compromised cardiopulmonary status or patients in whom a febrile or systemic reaction could present a significant risk. Administer IM preferably in the deltoid muscle in adults or the anterolateral thigh muscle in infants and small children. Do not administer IV or intradermally, subcutaneous route may be used in patients who are at high risk for hemorrhage following IM injection,