プロトロンビン複合体濃縮製剤 PCC
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
- draw together or meet in one common center; "These groups concentrate in the inner cities"
- make denser, stronger, or purer; "concentrate juice"
- a concentrated example of something; "the concentrate of contemporary despair"
- a concentrated form of a foodstuff; the bulk is reduced by removing water
- direct ones attention on something; "Please focus on your studies and not on your hobbies" (同)focus, center, centre, pore, rivet
- of or relating to a solution whose dilution has been reduced
- gathered together or made less diffuse; "their concentrated efforts"; "his concentrated attention"; "concentrated study"; "a narrow thread of concentrated ore"
- intensely focused; "her concentrated passion held them at bay"
- a protein in blood plasma that is the inactive precursor of thrombin (同)factor_II
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)
- (…に)〈光線・注意など〉'を'『集中する』《+『on』+『名』》 / 〈液体など〉'を'濃縮する / 《副詞[句]を伴って》(…に)『集中する』 / 専念する《+『on』+『名』》 / 濃縮したもの,濃縮液
- 集中した / 濃縮した
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/03/31 14:20:58」(JST)
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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, Cofact |
AHFS/Drugs.com |
entry |
Routes of
administration |
Injection |
Legal status |
|
Identifiers |
CAS Number |
37224-63-8 |
ATC code |
B02BD01 (WHO) |
Prothrombin complex concentrate (PCC, trade names Beriplex, Octaplex,[1] Kcentra, Cofact, among others) is a combination of blood clotting factors II, VII, IX and X, as well as protein C and S,[1] prepared from fresh-frozen human blood plasma. It is used to reverse the effects of oral anticoagulation therapy when bleeding occurs (e.g. in the brain or gut) requiring rapid action to accelerate coagulation.
PCC is effective but expensive. In the UK, it is prescribed in discussion with a haematologist. It is available as a powder and solvent for solution for injection.
Contents
- 1 Indications
- 2 Contraindications
- 3 History
- 4 References
- 5 External links
Indications
PCC reverses the effects of warfarin and other coumarin 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. Other indications include a deficiency of one of the included clotting factors, either congenital or due to liver disease, and hemophilia.
Several guidelines, including American College of Chest Physicians,[2] recommend PCC for warfarin reversal in patients with serious bleed.[3][4][5]
Contraindications
The package insert states that PCC is contraindicated in patients with disseminated intravascular coagulation, a pathological activation of coagulation,[6] 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.[6]
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.
References
- ^ a b FASS.se (Farmaceutiska Specialiteter i Sverige - the Swedish official drug catalog) > Ocplex Last updated: 2009–09–03
- ^ "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
External links
- Beriplex package insert from CSL Behring[dead link]
- Kcentra official site from CSL Behring
- Pabinger, I.; Brenner, B.; Kalina, U.; Knaub, S.; Nagy, A.; Ostermann, H.; Beriplex P/N Anticoagulation Reversal Study Group (2008). "Prothrombin complex concentrate (Beriplex®P/N) for emergency anticoagulation reversal: A prospective multinational clinical trial". Journal of Thrombosis and Haemostasis 6 (4): 622–631. doi:10.1111/j.1538-7836.2008.02904.x. PMID 18208533.
- Bruce, D.; Nokes, T. J. (2008). "Prothrombin complex concentrate (Beriplex P/N) in severe bleeding: Experience in a large tertiary hospital". Critical Care 12 (4): R105. doi:10.1186/cc6987. PMC 2575594. PMID 18706082.
Antihemorrhagics (B02)
|
|
Antihemorrhagics
(coagulation) |
Systemic |
Vitamin K |
- Phytomenadione (K1)
- Menadione (K3)
|
|
Coagulation
factors |
- intrinsic: IX/Nonacog alfa
- VIII/Moroctocog alfa/Turoctocog alfa
- extrinsic: VII/Eptacog alfa
- common: X
- II/Thrombin
- I/Fibrinogen
- combinations: Prothrombin complex concentrate (II, VII, IX, X, protein C and S)
|
|
Other
systemic |
- Etamsylate
- Carbazochrome
- Batroxobin
- thrombopoietin receptor agonist (Romiplostim
- Eltrombopag)
|
|
|
Local |
- Absorbable gelatin sponge
- Oxidized cellulose
- Tetragalacturonic acid hydroxymethylester
- Thrombin
- Collagen
- Calcium alginate
- Epinephrine/Adrenalone
|
|
|
Antifibrinolytics |
- amino acids (Aminocaproic acid
- Tranexamic acid
- Aminomethylbenzoic acid)
serpins (Aprotinin
- Alfa1 antitrypsin
- C1-inhibitor
- Camostat)
|
|
UpToDate Contents
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English Journal
- Hemostatic resuscitation in postpartum hemorrhage - a supplement to surgery.
- Ekelund K1, Hanke G1, Stensballe J2,3, Wikkelsøe A4, Albrechtsen CK1, Afshari A1.
- Acta obstetricia et gynecologica Scandinavica.Acta Obstet Gynecol Scand.2015 Jul;94(7):680-92. doi: 10.1111/aogs.12607. Epub 2015 Mar 5.
- BACKGROUND: Postpartum hemorrhage is a potentially life-threatening albeit preventable condition that persists as a leading cause of maternal death. Identification of safe and cost-effective hemostatic treatment options remains crucial as a supplement to surgery and uterotonic agents.OBJECTIVE: This
- PMID 25660118
- An Exploratory Cohort Study Comparing Prothrombin Complex Concentrate and Fresh Frozen Plasma for the Treatment of Coagulopathy After Complex Cardiac Surgery.
- Ortmann E1, Besser MW, Sharples LD, Gerrard C, Berman M, Jenkins DP, Klein AA.
- Anesthesia and analgesia.Anesth Analg.2015 Jul;121(1):26-33. doi: 10.1213/ANE.0000000000000689.
- BACKGROUND: Administration of coagulation factor concentrates to treat bleeding after cardiac surgery with cardiopulmonary bypass might be a strategy for reducing allogeneic blood transfusions, particularly for patients treated with warfarin preoperatively. We performed an exploratory analysis on wh
- PMID 25822921
- Rapid Anticoagulation Reversal With Prothrombin Complex Concentrate Before Emergency Brain Tumor Surgery.
- Beynon C1, Potzy A, Jungk C, Unterberg AW, Sakowitz OW.
- Journal of neurosurgical anesthesiology.J Neurosurg Anesthesiol.2015 Jul;27(3):246-51. doi: 10.1097/ANA.0000000000000104.
- BACKGROUND: Brain tumors may become symptomatic due to intracranial hypertension and patients may present to emergency departments in life-threatening conditions. Hence, emergency brain tumor surgery has to be considered, but sufficient hemostasis has to be present when initiating surgical procedure
- PMID 25105827
Japanese Journal
- Computational simulation and comparison of prothrombin complex concentrate dosing schemes for warfarin reversal in cardiac surgery
- 地方病院の救命救急センター・集中治療部門における薬剤師業務の現状
- Xa 阻害薬による抗凝固療法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
Related Links
- Kcentra ®, Prothrombin Complex Concentrate (Human), is a blood coagulation factor replacement product indicated for the urgent reversal of acquired coagulation factor deficiency induced by Vitamin K antagonist (VKA, e.g., warfarin ...
- Indications [edit] PCC reverses the effect of warfarin and other coumarin anti-coagulants and is used in cases of significant bleeding in patients with a coagulopathy (INR > 8.0, prolonged prothrombin time, raised d-dimer). It is also ...
Related Pictures
★リンクテーブル★
[★]
プロトロンビン複合体濃縮製剤, prothrombin complex concentrate
[★]
- 英
- prothrombin complex concentrate, PCC
[★]
- 関
- complexes、complicated、composite、conjugate、intricate
[★]
- 関
- attentive、centralize、conc.、concentrated、concentration、condensation、enrich、enrichment、focus
[★]
- 関
- conc.、concentrate、concentration、condensation、enrich、enrichment
[★]
- 関
- hybrid、mixed lineage、mixed type、mixed-type
[★]
- 関
- complex、composite