Difference between revisions of "Prothrombin complex concentrates"

(Common)
(Common)
Line 33: Line 33:
  
 
===Common===
 
===Common===
*Thromboembolic events (7%)
+
*Thromboembolic events
*[[headache]] (7.8%)
+
*[[Headache]]  
*[[hypotension]] (4.9%)
+
*[[Hypotension]] (4.9%)
*[[nausea/vomiting]]
+
*[[Nausea/vomiting]]
*arthralgia
+
*Arthralgia
 
*[[ICH]] (2.9%)
 
*[[ICH]] (2.9%)
*mental status change (2.9%)
+
*Mental status change
*hypertension (2.9%)
+
*Hypertension (2.9%)
  
 
==Pharmacology==
 
==Pharmacology==

Revision as of 03:01, 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

  • 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