Original communication| Volume 9, ISSUE 2, P212-219, February 1941

Oral and parenteral use of synthetic vitamin K-active substances in hypoprothrombinemia

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      In a study of 30 patients with miscellaneous diseases and prothrombin deficiency, the following impressions were obtained:
      • 1.
        1. 2-methyl-1,4-naphthoquinone, its dipropionyl derivative, and its sodium bisulfite derivative have satisfactory vitamin K-potency taken orally or parenterally in dosage of 1 to 4 mg. daily.
      • 2.
        2. No evidence of toxicity was seen in giving as much as 20 mg. of 2-methyl-1,4-naphthoquinone intravenously in one dose.
      • 3.
        3. The prothrombin response to treatment appears within twenty-four hours and lasts less than a week after vitamin K therapy is ended. The daily administration of vitamin K is desirable in treating hypoprothrombinemia.
      • 4.
        4. Prothrombin deficiency refractory to treatment may be seen in severe liver damage and in chronic sepsis.
      • 5.
        5. The effectiveness of 2-methyl-1,4-naphthoquinone taken by mouth is increased by taking deoxycholic acid or bile salts, even in the absence of jaundice.
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        • Fieser L.F.
        The Synthesis of Vitamin K.
        Science. 1940; 91: 31
        • Ansbacher S.
        • Fernholz E.
        • Dolliver M.A.
        Vitamin K-Active Derivatives of 2-Methyl-1,4-Naphthoquinone.
        J. Am. Chem. Soc. 1940; 62: 430
        • Fernholz E.
        • Ansbacher S.
        • MacPhillamy H.B.
        The Vitamin K Activity of Naphthoquinones.
        J. Am. Chem. Soc. 1940; 62: 430
        • Butt H.R.
        • Snell A.M.
        • Osterberg A.E.
        • Bollman J.L.
        Treatment of Hypoprothrombinemia: Use of Various Synthetic Compounds Exhibiting Antihemorrhagic Activity (Vitamin K Activity).
        in: Proc. Staff Meet., Mayo Clin. 15. 1940: 69
        • Andrus W.DeW.
        • Ford Jr., J.W.
        Correction of Prothrombin Deficiencies by Means of 2-Methyl-1,4-Naphthoquinone Injected Intramuscularly.
        J. A. M. A. 1940; 114: 1336
        • Warner E.D.
        • Brinkhous K.M.
        • Smith H.P.
        Quantitative Study on Blood Clotting: Prothrombin Fluctuations under Experimental Conditions.
        Am. J. Physiol. 1936; 114: 667
        • Stewart J.D.
        • Rourke G.M.
        Prothrombin and Vitamin K Therapy.
        New England J. Med. 1939; 221: 403
      1. Personal communication from Dr. Carl Nielsen.

      2. Personal communication from Dr. A. Black.

        • Stewart J.D.
        Prothrombin Deficiency and the Effects of Vitamin K in Obstructive Jaundice and Biliary Fistula.
        Ann. Surg. 1939; 109: 588