Prothrombin complex concentrate

Prothrombin complex concentrate (PCC) is a medication used to treat and prevent bleeding in patients with deficiencies of certain clotting factors. It is a combination of several blood clotting factors, including factor II, factor VII, factor IX, and factor X. PCC is often used in situations where rapid reversal of anticoagulation is necessary, such as in patients taking warfarin who are experiencing severe bleeding or require emergency surgery.

Composition

Prothrombin complex concentrate contains a mixture of the following clotting factors:

• Factor II (Prothrombin)
• Factor VII (Proconvertin)
• Factor IX (Christmas factor)
• Factor X (Stuart-Prower factor)

Some formulations of PCC may also contain small amounts of protein C and protein S, which are natural anticoagulants.

Indications

PCC is primarily indicated for:

• Rapid reversal of warfarin anticoagulation in patients with major bleeding or those requiring urgent surgical procedures.
• Treatment of bleeding episodes in patients with congenital deficiencies of the included clotting factors.
• Management of bleeding in patients with acquired deficiencies of these factors, such as those with liver disease.

Mechanism of Action

PCC works by replenishing the deficient clotting factors in the blood, thereby restoring the normal clotting process. This helps to control and prevent bleeding in patients with clotting factor deficiencies.

Administration

PCC is administered intravenously. The dosage and rate of administration depend on the severity of the bleeding, the patient's weight, and the specific product being used. It is important to monitor the patient's coagulation status and adjust the dosage accordingly.

Side Effects

Common side effects of PCC include:

• Thrombosis (formation of blood clots)
• Allergic reactions
• Headache
• Nausea

Patients receiving PCC should be monitored for signs of thrombosis and other adverse reactions.

Contraindications

PCC should not be used in patients with:

• Known hypersensitivity to any component of the product
• Disseminated intravascular coagulation (DIC) without appropriate anticoagulation

Monitoring

Patients receiving PCC should have their coagulation parameters closely monitored, including prothrombin time (PT) and international normalized ratio (INR). Regular monitoring helps to ensure the effectiveness of the treatment and to adjust dosages as needed.

See Also

• Warfarin
• Anticoagulation
• Coagulation
• Factor II
• Factor VII
• Factor IX
• Factor X