Which medications in the drug class Antidotes, Other are used in the treatment of Warfarin and Superwarfarin Toxicity?

Updated: Jan 19, 2018
  • Author: Kent R Olson, MD, FACEP; Chief Editor: David Vearrier, MD, MPH  more...
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Answer

Antidotes, Other

Activated charcoal is empirically used to minimize systemic absorption of the toxin.

Vitamin K1 is used in the management of poisoning and overdose, in the prevention of toxic effects, and in metabolic disorders in which toxic substances accrue.

Activated charcoal (Actidose-Aqua, Char-Caps, Kerr Insta-Char)

Activated charcoal is the emergency treatment used for poisoning caused by drugs and chemicals. A network of pores present in activated charcoal adsorbs 100-1000 mg of drug per gram of charcoal. Activated charcoal does not dissolve in water.

Administer activated charcoal to patients who present 1-2 hours postingestion or to patients in whom co-ingestants may delay gastric emptying or gut motility; minimal benefit is expected if more than 4 hours have passed since the ingestion.

Phytonadione (MEPHYTON)

Phytonadione (Vitamin K1) can overcome competitive block produced by warfarin and other, related anticoagulants. (Note that vitamin K3 [menadione] is not effective for this purpose.) The clinical effect is delayed for several hours while liver synthesis of clotting factors is initiated and plasma levels of clotting factors II, VII, IX, and X are gradually restored.

Vitamin K1 is not to be administered prophylactically; use only if evidence of anticoagulation exists. The required dose varies with the clinical situation, including the amount of anticoagulant ingested and whether it is a short-acting or long-acting anticoagulant.


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