Vitamin K (Phylloquinone, Menoquinone)

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Mind Map on Vitamin K (Phylloquinone, Menoquinone), created by hadeel.seraj on 17/11/2014.
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Mind Map by hadeel.seraj, updated more than 1 year ago
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Resource summary

Vitamin K (Phylloquinone, Menoquinone)
  1. Exists in several forms: phylloquinone (K1) found in plants and menaquinone (K2) formed by bacteria.
    1. Menadione (K3) is a synthetic derivative for therapy, used in the form of intramuscular or intravenous injections
      1. All neonates (sterile GIT) should be given a single prophylactic dose of vitamin K as phylloquinone by mouth
        1. Sometimes vitamin K is administrated before operations to reduce bleeding in surgery
          1. Anticoagulants (dicumarol and warfarin) are designed to work as vitamin K antagonists
            1. Developed for clinical management in patients at risk of thrombosis
              1. Functions
                1. Vitamin K-dependent carboxylase activity is necessary for formation of:
                  1. γ-carboxyglutamate residues
                  2. Enhances osteocalcin (protein in bone matrix, containing γ-carboxyglutamate residues) synthesis → functions as Ca binding protein and modifies crystallization of bone.
                    1. Synthesis of at least 4 blood clotting factors (contain γ-carboxyglutamate residues), among them prothrombin (factor II), the zymogen of blood coagulation enzyme thrombin → interaction with platelets → blood clotting
                    2. Role of Vitamin K in Blood Coagulation
                      1. At least 13 proteins and Ca ions are involved in blood clotting
                        1. γ-carboxyglutamate residues in blood clotting factors chelate Ca ions and so permit their binding to lipid membranes of platelets
                          1. In vitamin K deficiency or in the presence of its antagonist → pre-prothrombin is released into circulation
                            1. Pre-prothrombin is an abnormal precursor of prothrombin containing few or no γ-carboxyglutamate residues
                              1. Pre-prothrombin cannot chelate Ca ions or bind to lipid membrane and so is unable to initiate blood clotting
                      2. Deficiency
                        1. Deficiency causes increased chance of internal bleeding (after a minor cut) and uncontrollable haemorrhage (following a slight trauma).
                          1. The only known symptom is bleeding tendency with a prolonged PT (prothrombin time)
                            1. Combination of antibiotics, inadequate vitamin K intake, and surgery raises a warning flag that clotting time should be checked before surgery is performed !!
                            2. Toxicity
                              1. Excessive bleeding produced by the administration of oral anticoagulant (overdose) can be corrected by vitamin K administration
                                1. However, high doses of vitamin K can reduce the effectiveness of anticoagulants used to prevent blood clotting
                                  1. Symptoms are hemolytic anemia and jaundice in infants
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