Prothrombin, Deficiency

Ora/. Anticoagulant-induced prothrombin deficiency (see Warnings) hypoprothrombinemia secondary to salicylates or antibacterial therapy hypoprothrombinemia secondary to obstructive jaundice and biliary fistulas, but only if bile salts are administered concomitantly with phytonadione. 

Parenteral Anticoagulant-induced prothrombin deficiency hypoprothrombinemia secondary to conditions limiting absorption or synthesis of vitamin K (eg, obstructive jaundice, biliary fistula, sprue, ulcerative colitis, celiac disease, intestinal resection, cystic fibrosis of the pancreas, regional enteritis) drug-induced hypoprothrombinemias due to interference with vitamin K metabolism (eg, antibiotics, salicylates) prophylaxis and therapy of hemorrhagic disease of the newborn. 

Inject subcutaneously or IM when possible. In older children and adults, inject IM in the upper outer quadrant of the buttocks. In infants and young children, the anterolateral aspect of the thigh or the deltoid region is preferred. When IV administration is unavoidable, inject very slowly, not exceeding 1 mg/min. Anticoagulant-induced prothrombin deficiency in adults 2.5 to 10 mg or up to 25 mg (rarely, 50 mg) initially. Determine subsequent doses by prothrombin time (PT) response or clinical condition. If in 6 to 8 hours after parenteral administration (or 12 to 48 hours after oral administration), the PT has not been shortened satisfactorily, repeat dose. If shock or excessive blood loss occurs, transfusion of blood or fresh frozen plasma may be required. 

II Prothrombin deficiency 30-40% 3 days Prothrombin complex concentrates (intermediate purity factor IX concentrates)... 

Factor deficiencies include disorders of fibrinogen such as afibrinogenemia and dysfibrinogenemias, prothrombin deficiency, factor V VII, X, XI, XII, and XIII deficiency, prekallikrein and high-molecular-weight kininogen deficiency, combined factor deficiencies, a2 anti-plasmin deficiency, a] antitrypsin Pittsburgh, and protein Z deficiency. 

Sun WY, Witte DP, Degen JL et al. (1998) Prothrombin deficiency results in embryonic and neonatal lethality in mice. Proc Natl Acad Sci USA 95 7597-7602 Xu J, Wu Q, Westfield L et al. (1998) Incomplete embryonic lethality and fatal neonatal hemorrhage caused by prothrombin deficiency in mice. Proc Natl Acad Sci USA 95 7603-7607... 

G6. Girolami, A., Patrassi, G., Tofikinin, F., and Sagin, L., Chromogenic substrate (S-2238) prothrombion assay in prothrombin deficiencies and abnormalities. Am. ]. Clin. Pathol. 74, 83-87 (1980). 

Vitamin K, Unknown Activation of prothrombin deficiency causes disorders in blood clotting. 1 mg... 

Schofield first described the sweet clover disease of cattle as a defect in blood clotting [2]. It has been shown since that this disease is connected with prothrombin deficiency [403, 404]. Later, the coumarin structure was recognised as the toxic agent of spoiled sweet clover hay responsible for the anticoagulant activity [34]. The bis-hydroxycoumarin (61) (dicoumarol) as the prototype of these compounds, was isolated from clover [33, 405] and applied in therapy [406-408]. 

Thromblastin Component Deficiency 407 Deficiency of the Hageman Factor 407 Prothrombin Deficiencies 408 Fibrinopenia 408 Vitamin K Deficiency 409... 

Another quinone important in biological systems is vitamin K. This compound was discovered in 1935 as a result of a study of newly hatched chicks with a fatal disease in which their blood was slow to dot. It was later discovered that the delayed clotting time of blood was caused by a deficiency of prothrombin. We now know that a prothrombin deficiency is, in turn, caused by a deficiency in vitamin K, which is essential to the synthesis of prothrombin in the liver. The natural form of vitamin has a chain of five to eight isoprene units bonded to a 1,4-naphthoquinone ring. Figure 21.15 shows seven isoprene units in the side chain. 

It is well established that a prothrombin deficiency c.xists during the first few days of the neonatal period in man and that administration of vitamin K to the mother before delivery or to the infant increases the prothrombin values (147). But there is little evidence that the hypoprothrombinemia of infants is due to a dietary deficiency of the mother. 

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