Prothrombin complex concentrates: Difference between revisions
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===Serious=== | ===Serious=== | ||
*thromboembolism | *Patients receiving PCC for reversal of a vitamin K antagonist ([[Warfarin]]) due to life-threatening bleeding have a rate of thromboembolism which is similar to the rate in patients who receive [[Fresh frozen plasma]] (7.3% v 7.1%).<ref>Milling, TJ Jr et al. Thromboembolic events after vitamin K antagonist reversal with 4-factor prothrombin complex concentrate: exploratory analyses of two randomized, plasma-controlled studies. Ann Emerg Med. 2016 Jan;67(1):96-105. PMID: 26094105</ref> | ||
===Common=== | ===Common=== | ||
*thromboembolic events (8.7%) | *thromboembolic events (8.7%) | ||
Revision as of 02:55, 10 June 2016
General
- Type: Hemostatics, blood components
- Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
- Common Trade Names: Kcentra
Adult Dosing
- Based on pretreatment INR, units based on factor 9 content
- INR 2-4: 25units/kg, not to exceed 2500 units
- INR 4-6: 35units/kg, not to exceed 3500 units
- INR >6: 50units/kg, not to exceed 5000 units
- Conisder rechecking INR after 15 minutes to determine need for redosing
Pediatric Dosing
Safety and efficacy not established
Special Populations
- Pregnancy Rating: C
- Lactation: Unknown, breast feeding not advised
- Renal Dosing
- Adult-N/A
- Pediatric-N/A
- Hepatic Dosing
- Adult-N/A
- Pediatric-N/A
Contraindications
Serious
- Patients receiving PCC for reversal of a vitamin K antagonist (Warfarin) due to life-threatening bleeding have a rate of thromboembolism which is similar to the rate in patients who receive Fresh frozen plasma (7.3% v 7.1%).[1]
Common
- thromboembolic events (8.7%)
- headache (7.8%)
- hypotension (4.9%)
- nausea/vomiting
- arthralgia
- ICH (2.9%)
- mental status change (2.9%)
- hypertension (2.9%)
Pharmacology
- Half-life: 4-60 hours, depending on clotting factor
- Metabolism:
- Excretion:
- Mechanism of Action: 4 factor PCC contains factors II, VII, XI, X, protein C and S
See Also
References
- ↑ Milling, TJ Jr et al. Thromboembolic events after vitamin K antagonist reversal with 4-factor prothrombin complex concentrate: exploratory analyses of two randomized, plasma-controlled studies. Ann Emerg Med. 2016 Jan;67(1):96-105. PMID: 26094105