CP-229 Antivitamin K overdose: how to use vitamin K1?

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Abstract

Background

In 2008, the French National Authority for Health produced recommendations regarding the management of patients treated with antivitamin K for overdose, bleeding or risk of bleeding.

Purpose

A retrospective study was conducted in our hospital to evaluate conformity of prescribing practices to these recommendations and to propose improvement actions if necessary.

Material and methods

All prescriptions of vitamin K1 were extracted from our software for a 2 month period, excluding prescriptions from the maternity ward and paediatrics. Only patients treated with antivitamin K were selected. We then collected the necessary data to determine if the prescriptions were consistent with the recommendations: target INR (international normalised ratio), route of administration, posology and indication.

Results

Overall, among the 24 (57.2%) prescriptions for vitamin K1 which were non-compliant with the recommendations, 19 were for over dose and 5 were for under dose.

Conclusion

This study showed an important rate of non-compliance with the recommendations regarding the management of patients treated with antivitamin K1 in situation of overdose, bleeding or risk of bleeding in our hospital. Failure to adhere to the recommended doses of vitamin K1 can cause difficulties in stabilising the INR after resumption of antivitamin K treatment. Furthermore, the prescriber’s attention was drawn to the recommendations through an oral presentation of the study and emails. We also reminded them of the existence of a form, included in the prescription software, designed to serve as a point of reference for the prescriber when vitamin K1 is needed.

Conclusion

No conflict of interest

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