WordNet

complicated in structure; consisting of interconnected parts; "a complex set of variations based on a simple folk melody"; "a complex mass of diverse laws and customs"
a compound described in terms of the central atom to which other atoms are bound or coordinated (同)coordination_compound
a conceptual whole made up of complicated and related parts; "the complex of shopping malls, houses, and roads created a new town" (同)composite
(psychoanalysis) a combination of emotions and impulses that have been rejected from awareness but still influence a persons behavior
be a contributing factor; "make things factor into a companys profitability"
any of the numbers (or symbols) that form a product when multiplied together
an independent variable in statistics
anything that contributes causally to a result; "a number of factors determined the outcome"
consider as relevant when making a decision; "You must factor in the recent developments" (同)factor in, factor out
resolve into factors; "a quantum computer can factor the number 15" (同)factor in, factor out
an event known to have happened or something known to have existed; "your fears have no basis in fact"; "how much of the story is fact and how much fiction is hard to tell"
a concept whose truth can be proved; "scientific hypotheses are not facts"
a piece of information about circumstances that exist or events that have occurred; "first you must collect all the facts of the case"
a statement or assertion of verified information about something that is the case or has happened; "he supported his argument with an impressive array of facts"
the 9th letter of the Roman alphabet (同)i

PrepTutorEJDIC

『いくつかの部分から成る』,複合の,合成の / 『複雑な』,入りくんだ,こみいった(complicated) / 複合体,合成物 / コンプレックス,複合(抑圧されて心に残った複雑なしこり)
(…の)『要因』,(…を生み出す)要素《+『in』+『名』(do『ing』)》 / 囲数,約数 / 代理人,《おもに英》仲買人 / =factorize
〈C〉『事実』,実際にある(あった)事 / 〈U〉真相,真実(truth) / 《the~》(法律用語で)犯行
『私は』私が
iodineの化学記号

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/08/20 12:50:44」(JST)

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[Wiki en表示]

Prothrombin complex concentrate (PCC), also known as factor IX complex, is a medication made up of blood clotting factors II, IX, and X.^[1] Some versions also contain factor VII.^[2] It is used to treat and prevent bleeding in hemophilia B if pure factor IX is not avaliable.^[1]^[3] It may also be used in those with not enough of these factors due to other reasons such as warfarin therapy.^[3] It is given by slow injection into a vein.^[1]

Common side effects include allergic reactions, headache, vomiting, and sleepiness.^[1]^[4] Other serious side effects include blood clots which may result in a heart attack, stroke, pulmonary embolism, or deep vein thrombosis.^[4] Antibodies may form after long term use such that future doses are less effective.^[3]

Prothrombin complex concentrate came into medical use in the 1960s.^[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.^[6]^[7] It is made from human plasma.^[4] A version that is made by recombinant methods which only contains factor IX is also avaliable.^[8] In the United States a dose of PCC costs about 900 USD.^[9] A number of different formulations are available globally.^[10]

Medical uses

PCC reverses the effects of warfarin and other vitamin K antagonist anti-coagulants and is used in cases of significant bleeding in patients with a coagulopathy (INR > 8.0, prolonged prothrombin time). It is also used when such a patient must undergo an emergency operation treatment.^[11] Other indications include a deficiency of one of the included clotting factors, either congenital or due to liver disease, and hemophilia.^[11] Several guidelines, including American College of Chest Physicians,^[12] recommend PCC for warfarin reversal in patients with serious bleed.^[13]^[14]^[15]

Contraindications

Platelet factor 4 can cause heparin-induced thrombocytopenia.

The package insert states that PCC is contraindicated in patients with disseminated intravascular coagulation, a pathological activation of coagulation,^[16] because giving clotting factors would only further fuel this process. However, if the PCC is given because factor levels are low, it can restore normal coagulation. As PCC products contain heparin, they are contraindicated in patients with heparin-induced thrombocytopenia.^[16]

Chemistry

PCC contains a number of blood clotting factors. Typically this includes factor II, IX, and X.^[1] Some versions also contain factor VII, protein C, and protein S.^[2] Heparin may be added to stop early activation of the factors.^[2]

History

The U.S. Food and Drug Administration (FDA) announced its approval of Kcentra on April 30, 2013. The FDA approved Kcentra's orphan drug status in December 2012.^[17]

References

^ ^a ^b ^c ^d ^e WHO Model Formulary 2008 (PDF). World Health Organization. 2009. pp. 259–260. ISBN 9789241547659. Retrieved 8 December 2016.
^ ^a ^b ^c Perkins, John C. (2014). Hematology/Oncology Emergencies, An Issue of Emergency Medicine Clinics of North America,. Elsevier Health Sciences. p. 720. ISBN 9780323320290.
^ ^a ^b ^c British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 171. ISBN 9780857111562.
^ ^a ^b ^c "Factor IX (Human), Factor IX Complex (Human)". The American Society of Health-System Pharmacists. Retrieved 8 December 2016.
^ Besa, Emmanuel C. (1992). Hematology. Lippincott Williams & Wilkins. p. 276. ISBN 9780683062229.
^ "19th WHO Model List of Essential Medicines (April 2015)" (PDF). WHO. April 2015. Retrieved May 10, 2015.
^ The selection and use of essential medicines: Twentieth report of the WHO Expert Committee 2015 (including 19th WHO Model List of Essential Medicines and 5th WHO Model List of Essential Medicines for Children). (PDF). WHO. 2015. p. 510. ISBN 9789240694941. Retrieved 8 December 2016.
^ "Factor IX (Recombinant)". The American Society of Health-System Pharmacists. Retrieved 8 December 2016.
^ Murray, Michael J.; Rose, Steven H.; Wedel, Denise J.; Wass, C. Thomas; Harrison, Barry A.; Mueller, Jeff T. (2014). Faust's Anesthesiology Review: Expert Consult (4 ed.). Elsevier Health Sciences. p. 543. ISBN 9781437703672.
^ Miller, Ronald D.; Eriksson, Lars I.; Fleisher, Lee A.; Wiener-Kronish, Jeanine P.; Cohen, Neal H.; Young, William L. (2014). Miller's Anesthesia (8 ed.). Elsevier Health Sciences. p. 1892. ISBN 9780323280112.
^ ^a ^b Haberfeld, H, ed. (2015). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. Cofact.
^ "ACCP 2012 guidelines: 'Evidence-Based Management of Anticoagulant Therapy, Section 9.3 Treatment of Anticoagulant-Related Bleeding'". Chest Journal.
^ Haemostasis and Thrombosis Task Force for the British Committee for Standards in Haematology. Guidelines on oral anticoagulation: 3rd edition. Br J Haematol. 1998;101:374-387.
^ Baker, R. I.; Coughlin, P. B.; Gallus, A. S.; Harper, P. L.; Salem, H. H.; Wood, E. M.; Warfarin Reversal Consensus, G. (2004). "Warfarin reversal: Consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis". The Medical journal of Australia. 181 (9): 492–497. PMID 15516194.
^ Palareti, G. (1998). "A guide to oral anticoagulant therapy. Italian Federation of Anticoagulation Clinics". Haemostasis. 28 Suppl 1: 1–46. PMID 9820837.
^ ^a ^b Kcentra Prescribing Information
^ "Kcentra, from CSL Behring, Receives FDA Approval for Use in Warfarin Reversal in Patients Undergoing Surgery". CSL Behring. 13 December 2013.

UpToDate Contents

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1. プロトロンビン複合体濃縮製剤（PCC）—4因子含有PCC、3因子含有PCCおよび活性型PCC製剤：製剤 prothrombin complex concentrates pccs 4 factor pcc 3 factor pcc and activated pcc products drug formulations
2. 血友病患者における第VIIIおよび第IX因子阻害物質 factor viii and factor ix inhibitors in patients with hemophilia
3. 第VIII因子および第IX因子の生物学と正常な機能 biology and normal function of factor viii and factor ix
4. 血友病の治療 treatment of hemophilia
5. 止血の概要 overview of hemostasis

English Journal

Optical imaging of pre-invasive breast cancer with a combination of VHHs targeting CAIX and HER2 increases contrast and facilitates tumour characterization.

Kijanka MM1, van Brussel AS2,3, van der Wall E4, Mali WP5, van Diest PJ6, van Bergen En Henegouwen PM7, Oliveira S8,9.
EJNMMI research.EJNMMI Res.2016 Dec;6(1):14. doi: 10.1186/s13550-016-0166-y. Epub 2016 Feb 10.
BACKGROUND: Optical molecular imaging is an emerging novel technology with applications in the diagnosis of cancer and assistance in image-guided surgery. A high tumour-to-background (T/B) ratio is crucial for successful imaging, which strongly depends on tumour-specific probes that rapidly accumula
PMID 26860296

[Rapid Report Hemophilia. Evidence in treatment of hemophilia from the IQWiG's perspective].

Bleß HH1, Schönfelder T, Talaschus A.
Hamostaseologie.Hamostaseologie.2016 Jun 8. [Epub ahead of print]
The German Institute for Quality and Efficiency in Health Care (IQWiG) conducted a rapid report to assess the therapy of hemophilia patients. Based on a systematic literature search the IQWiG identified 16 studies which show that there is now sufficient information regarding questions that previousl
PMID 27272286

Physical activity in individuals with haemophilia and experience with recombinant factor VIII Fc fusion protein and recombinant factor IX Fc fusion protein for the treatment of active patients: a literature review and case reports.

Wang M1, Álvarez-Román MT, Chowdary P, Quon DV, Schafer K.
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.Blood Coagul Fibrinolysis.2016 Jun 7. [Epub ahead of print]
The World Federation of Hemophilia and the National Hemophilia Foundation encourage people with haemophilia (PWH) to participate in routine physical activity. The benefits of physical activity for PWH include improvements in joint, bone, and muscle health. Accordingly, a number of studies suggest th
PMID 27116081

Japanese Journal

Vascularized subcutaneous human liver tissue from engineered hepatocyte/fibroblast sheets in mice

Biomaterials 65, 66-75, 2015-10
NAID 120005672449

血小板に魅せられて

山口医学 64(1), 5-9, 2015
NAID 130005151151

撤回：リバーロキサバン内服中に視床出血を発症し，第IX因子複合体製剤投与後も血腫増大を呈した1症例

臨床神経学 advpub(0), 2015
NAID 130005101984

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★リンクテーブル★

リンク元	「blood coagulation factor IX」「coagulation factor IX」
関連記事	「complex」「I」「fact」「factor」「complexed」

「blood coagulation factor IX」

Prothrombin complex concentrate
Combination of
Factor II	Blood clotting factor
Factor VII	Blood clotting factor
Factor IX	Blood clotting factor
Factor X	Blood clotting factor
Clinical data
Trade names	Beriplex, Octaplex, Kcentra, others
AHFS/Drugs.com	Monograph
Routes of; administration	injection
ATC code	B02BD01 (WHO);
Legal status
Legal status	In general: ℞ (Prescription only);
Identifiers
Synonyms	factor IX complex
CAS Number	37224-63-8;