Which of the following is advocated in dicoumarol poisoning: March 2005
**Core Concept**
Dicoumarol is a vitamin K antagonist that inhibits the production of vitamin K-dependent clotting factors in the liver, leading to an increased risk of bleeding. In cases of dicoumarol poisoning, it is essential to reverse the anticoagulant effect to prevent severe bleeding complications.
**Why the Correct Answer is Right**
The correct approach to managing dicoumarol poisoning involves administering vitamin K, which serves as a cofactor for the enzymes responsible for the carboxylation of vitamin K-dependent clotting factors. Vitamin K helps to restore the normal production of these clotting factors, thereby reversing the anticoagulant effect of dicoumarol. Additionally, fresh frozen plasma (FFP) or clotting factor concentrates may be administered to rapidly correct the coagulopathy.
**Why Each Wrong Option is Incorrect**
* **Option A:** Administering heparin would further exacerbate the coagulopathy by activating the intrinsic pathway and increasing the risk of bleeding.
* **Option B:** Activated charcoal may be considered for acute ingestion, but it is not the primary treatment for dicoumarol poisoning.
* **Option C:** Hemodialysis is not effective in removing dicoumarol from the body, as it is extensively bound to plasma proteins.
**Clinical Pearl / High-Yield Fact**
Vitamin K is the antidote of choice for dicoumarol poisoning, and it is essential to note that the reversal of anticoagulation may take several hours to days, depending on the severity of the poisoning and the patient's response to treatment.
**Correct Answer:** A. Vitamin K administration