What is Kcentra used for?

Kcentra, (Prothrombin Complex Concentrate (Human)), is indicated for the urgent reversal of acquired coagulation factor deficiency induced by Vitamin K antagonist (VKA, e.g., warfarin) therapy in adult patients with acute major bleeding.

Why does PCC contain heparin?

Both 3- and 4-factor PCC contain protein C and protein S, and some may also contain small amounts of heparin, which is added to prevent activation of the clotting proteins. PCC indicates prothrombin complex concentrate.

What is dried prothrombin complex?

Prothrombin complex is a sterile, freeze-dried powder containing purified human coagulation factors II, IX, and X, with antithrombin III. It commonly contains some factor VII, but the amount may vary. In surgery patients, prothrombin complex is indicated only for the rapid reversal of warfarin (see Table 30-11).

Why is PCC contraindicated in DIC?

Because they may increase the risk for thromboembolism, PCCs are not recommended for patients with antithrombin deficiency or disseminated intravascular coagulation, with a possible, rare exception in patients with potentially life-threatening clotting factor deficiency when no other alternative treatment is available …

How fast does Kcentra reverse INR?

Effective hemostasis measured up to 24 hours for the Acute Major Bleeding trial and until the end of procedure (up to 24 hours) for the Urgent Surgery/Invasive Procedures trial. Rapid INR reduction to ≤1.3 at 0.5 hours after end of infusion.

What is Kcentra the antidote for?

Kcentra is an FDA approved drug derived from blood that is used as an antidote to treat people with bleeding associated with taking the well-known anticoagulant warfarin. This is a Phase I, placebo-controlled, single site, open-label, crossover trial to evaluate the reversibility apixaban anticoagulation with Kcentra.

What factors does PCC contain?

The 3 factor-PCC contains factors II, IX, X, and little or no factor VII.

When do you give FFP vs PCC?

FFP is the standard of care in the United States ; however, FFP needs to be given in a dose of 15-20 mL/kg and therefore requires a large-volume infusion. PCC contains high levels of vitamin K-dependent cofactors and thus involves a smaller-volume infusion than FFP and more rapid administration.

How long does prothrombin complex concentrate last?

Data on PCC pharmacokinetics are scant. The half-lives of the four clotting factors differ widely. The half-life of FII is much longer (60–72 h) than that of the other factors (6–24 h). FVII has the shortest half-life (approximately 6 h)4.

When is prothrombin complex used?

Medical uses Prothrombin complex concentrate reverses the effects of warfarin and other vitamin K antagonist anti-coagulants and is used in cases of significant bleeding in people with a coagulopathy. It is also used when such a person must undergo an emergency operation treatment.

What is 4 factor prothrombin complex concentrate?

The 4-factor prothrombin complex concentrate (4F-PCC), which contains the human coagulation factors II, VII, IX and X together with the endogenous inhibitor proteins S and C, is indicated for the urgent reversal of acquired coagulation factor deficiency induced by VKA (e.g. warfarin or coumarin) therapy in adult …

How much FFP does it take to reverse INR?

Give FFP 2 units IV by rapid infusion. Check INR 15 minutes after completion of infusion. If INR ≥1.5, administer 2 additional units of FFP IV rapid infusion. Repeat process until INR ≤1.5.

What do you need to know about prothrombin complex concentrate?

Prothrombin Complex Concentrate (PCC) FACTSHEET 1. What is it? Prothrombin Complex Concentrate (PCC) is a combination of blood clotting factors II, VII, IX and X with Protein C and Protein S. It is a human derived pooled plasma product which is virally inactivated. Over anti-coagulation can occur from excessive warfarin.

How is the anticoagulation of prothrombin measured?

Associated laboratory tests The level of anticoagulation is assessed by the prothrombin time (PT) standardised by the international normalised ratio (INR). The dose of PCC will depend on the INR before treatment and the targeted INR. The dose should be calculated according to the weight of the patient. 6.

How does warfarin work to prevent over coagulation?

It is a human derived pooled plasma product which is virally inactivated. Over anti-coagulation can occur from excessive warfarin. Warfarin achieves its anticoagulation by inhibiting the vitamin K effect on factor II, factor VII, factor IX and factor X, causing a functional deficiency of these factors and of anticoagulant proteins C and S. 2.