Clotting factor concentrates
Class Summary
Clotting factor concentrates promote hemostasis by providing the deficient clotting factor to the coagulation cascade. Used for control and prevention of hemorrhagic episodes and surgical prophylaxis in patients with factor VII (FVII) deficiency.
Factor VIIa, recombinant (FVII Concentrate)
Vitamin K–dependent glycoprotein that promotes hemostasis by activating extrinsic pathway of coagulation cascade. FVII concentrates, available from Baxter or Bio Products Laboratory (United Kingdom), are purified plasma–derived concentrates that have undergone viral inactivation with vapor heat.
Coagulation FVIIa, recombinant (NovoSeven)
Activated FVII promotes hemostasis by activating the extrinsic pathway of coagulation cascade. Originally developed to treat patients with FVIII inhibitors. Doses lower than those recommended for patients with hemophilia are usually effective in patients with FVII deficiency.
Antifibrinolytic agents
Class Summary
These agents are used to enhance hemostasis when fibrinolysis contributes to bleeding. They inhibit lysis of the fibrin clot and thus maintain hemostasis once achieved. Antifibrinolytics are particularly useful for bleeding from mucosal surfaces where fibrinolytic activity is high, such as the nose or oropharynx.
Aminocaproic acid (Amicar)
Lysine analogue that inhibits fibrinolysis by blocking binding of plasmin or plasminogen activators to lysine residues on fibrin.
Tranexamic acid (Cyklokapron)
Alternative to aminocaproic acid. Lysine analogue that inhibits fibrinolysis by blocking binding of plasmin or plasminogen activators to lysine residues on fibrin.
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Intrinsic and extrinsic pathways of coagulation. Factor VII/tissue factor complex activates factor IX and factor X. Factor IXa along with factor VIIIa results in formation of more factor Xa. Factor Xa along with factor Va converts prothrombin to thrombin.
