Prothromplex

Prothromplex is a drug used to treat acute severe bleeding conditions caused by acquired coagulopathy. These are mainly conditions during direct (e.g. NOAC) and indirect ( Warfarin ) anticoagulant therapy. It is a mixture of human coagulation factors II, VII, IX, X, and Protein C. It is produced in a package containing 600 IU in 20 ml. For an idea, it contains as much coagulation factors as 600 ml of frozen plasma.

Indications
With regard to possible thrombogenic complications of drug use, the indication must be carefully considered. It is about:


 * life-threatening bleeding conditions - given by the volume of blood loss or localization (hemorrhage into the CNS )
 * conditions requiring urgent surgery - typically NPB, including damage control surgery

Serious Side effects
Development of thromboembolic disease, disseminated intravascular coagulopathy allergic reaction, heart failure or myocardial infarction

Dosage
Dosage recommendations are given in units of IU/kg of patient weight.  NOACs cannot be guided by INR
 * in hypocoagulable states in patients on Warfarin
 * in hypocoagulable states in patients on NOAC therapy - recommended dose 30-50 IU/kg

Related articles

 * anticoagulants

Reference

 * 1) Summary of Product Characteristics, PROTHROMPLEX TOTAL NF: PROTHROMPLEX TOTAL NF [online]. SÚKL, 2015 [cit. 2016-4-15]. Available from: https://www.sukl.cz/modules/medication/detail.php?code=0075634
 * 2) ↑Jump up to:a b c FENGER-ERIKSEN, C. New oral anticoagulants: clinical indications, monitoring and treatment of acute bleeding complications. Acta Anaesthesiologica Scandinavica [online]. 58 n. l., 2014 (6), 651-659 [cit. 2016-04-15]. DOI: 10.1111/aas.12319.
 * 3) ↑Jump up to:a b c PEACOCK, W. Frank. Emergency Management of Bleeding Associated With Old and New Oral Anticoagulants. Clinical Cardiology [online]. 2012, 35 (12), 730-737 [cit. 2016-04-15]. DOI: 10.1002/clc.22037.
 * 4) ↑Jump up to:a b Life-threatening bleeding - recommended practice consensus opinion [online]. Prague: Czech Hematology Society ČLS JEP [cit. 2016-4-15]. Available from: http://www.hematology.cz/doporuceni/klinika-files/Doporuceni_CHS_CLS_JEP-Zivot_ohrozujici_krvaceni.pdf.