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Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Vitamin K prophylaxis in newborns.

Sophie Jullien1

  • 1Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain. sophjullien@gmail.com.

BMC Pediatrics
|September 9, 2021
PubMed
Summary

All newborns need vitamin K prophylaxis after birth to prevent hemorrhagic disease of the newborn (HDN). Both oral and intramuscular vitamin K are effective, with no significant difference noted between routes if oral doses are completed.

Keywords:
Haemorrhagic disease of newbornNewbornVitamin K deficiency bleedingVitamin K prophylaxis

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Area of Science:

  • Neonatal Medicine
  • Pediatric Pharmacology
  • Public Health

Background:

  • Hemorrhagic disease of the newborn (HDN) is a serious condition in infants.
  • Vitamin K prophylaxis is a standard intervention to prevent HDN.
  • Existing evidence on vitamin K's effectiveness requires synthesis.

Purpose of the Study:

  • To review current recommendations and evidence on vitamin K's effectiveness in preventing HDN.
  • To assess the strength of recommendations and certainty of evidence for vitamin K prophylaxis.

Main Methods:

  • Conducted a literature search up to December 10, 2019.
  • Included key terms and manual searches in selected sources.
  • Summarized recommendations, strength of recommendations, and systematic review findings.

Main Results:

  • Oral and intramuscular vitamin K are effective in preventing classical HDN.
  • No significant difference between oral and intramuscular routes for preventing classical and late HDN, assuming complete oral administration.
  • Limited evidence exists for vitamin K prophylaxis in preterm infants and for late HDN prevention via randomized trials.

Conclusions:

  • Vitamin K prophylaxis is recommended for all newborns to prevent HDN.
  • Current evidence supports both oral and intramuscular routes, with comparable efficacy.
  • Further research is needed, particularly for late HDN and in preterm infants.