The exact mechanism by which bishydroxycoumarin (dicumarol®) affects the blood coagulation system is still unknown. The similarity in the chemical structure of 3-substituted 4-hydroxycoumarins to vitamin K led the original workers1 to suggest that bishydroxycoumarin might act by blocking or competing with vitamin K in maintaining prothrombin activity. This hypothesis was supported by animal experiments which demonstrated the similarity of vitamin K deficiency to the biologic response to bishydroxycoumarin2 and the ability of vitamin K to reverse the action of this drug.3 However, it was clearly shown that the levels of 2-methyl-1, 4-naphthoquinone necessary to counteract the action of the anticoagulant are considerably larger
Overman RS, Sorenson CW, Wright IS. EFFECTIVENESS OF SYNTHETIC WATERSOLUBLE VITAMIN K PREPARATIONS IN BISHYDROXYCOUMARIN-INDUCED HYPOPROTHROMBINEMIA. JAMA. 1951;145(6):393–399. doi:10.1001/jama.1951.02920240029008
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