Difference between revisions of "Prothrombin complex concentrates"

(Common)
(References)
 
(3 intermediate revisions by 3 users not shown)
Line 3: Line 3:
 
*Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
 
*Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
 
*Common Trade Names: Kcentra
 
*Common Trade Names: Kcentra
 +
*3 factor PCC (Factors II, IX, and X), would need to supplement with factor VII for reversal if using 3 factor PCC
 +
*4 factor PCC (Factors II, VII, IX, and X)
  
 
==Adult Dosing==
 
==Adult Dosing==
Line 9: Line 11:
 
**INR 4-6: 35units/kg, not to exceed 3500 units
 
**INR 4-6: 35units/kg, not to exceed 3500 units
 
**INR >6: 50units/kg, not to exceed 5000 units
 
**INR >6: 50units/kg, not to exceed 5000 units
*Conisder rechecking INR after 15 minutes to determine need for redosing
+
*Consider rechecking INR after 15 minutes to determine need for redosing
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
Safety and efficacy not established
+
*Safety and efficacy not established
  
 
==Special Populations==
 
==Special Populations==
Line 49: Line 51:
  
 
==See Also==
 
==See Also==
*[[Blood transfusions]]
+
*[[Anticoagulant reversal for life-threatening bleeds]]
*[[Dabigatran (Pradaxa) Reversal]]
+
*[[Anti-platelet agent reversal]]
 +
*[[Blood products]]
 +
*[[Warfarin reversal]]
  
 
==References==
 
==References==
 
<references/>
 
<references/>
 +
 
[[Category:Pharmacology]]
 
[[Category:Pharmacology]]
 +
[[Category:Heme/Onc]]

Latest revision as of 22:09, 23 September 2019

General

  • Type: Hemostatics, blood components
  • Dosage Forms:lypophilized concentrate for reconstitution 500u/vial and 1000u/vial
  • Common Trade Names: Kcentra
  • 3 factor PCC (Factors II, IX, and X), would need to supplement with factor VII for reversal if using 3 factor PCC
  • 4 factor PCC (Factors II, VII, IX, and X)

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
  • Consider 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

  • Allergy to class/drug
  • DIC
  • known HIT (Heparin induced thrombocytopenia)

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

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

  1. 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