winds022

What is the preferred route of Vitamin K administration in adults to treat elevated INR in the outpatient clinic setting? Our clinic protocol states that it can be given PO or IM. After doing some research, it appears that IM is no longer used. We have the neonatal formulation in our clinic that can be given SQ, but it appears that route is possibly no longer recommended either. It seems like oral and IV administration are the most current recommendations. I also came across a source that stated any parenteral vitamin K is not appropriate for outpatient use. What is happening out there in the "real world?"

Do most single-dose medication vials contain the amount of volume listed on the label or is there some overfill? For example, the vial can say 1 mL, but the amount of liquid in the syringe will read more than 1 mL (even with low dead space). I once asked a nurse why she was drawing up more than the required dose of 1 mL of a medication and she said, "because the label says there is 1 mL in the vial."