Prothrombin Complex Concentrate, Blood product, Hemostatic agent
Caution
CCP: Vitamin K antagonist reversal with major bleeding.
CCP: Non-vitamin K antagonists with life-threatening bleeding.
Adolescents ≥ 17 years of age: Refer to adult dosing.
Prothrombin complex concentrate provides an increase in the levels of the vitamin K-dependent coagulation factors (II, VII, IX, and X) with the addition of protein C and protein S. Coagulation factors II, IX, and X are part of the intrinsic coagulation pathway, while factor VII is part of the extrinsic coagulation pathway. In the extrinsic pathway, damaged blood vessels release endothelial tissue factor (TF) which complexes with factor VII to form TF-factor VIIa. Within the intrinsic pathway, factor IX is converted to IXa. Factor IXa (as well as TF-factor VIIa) converts factor X to factor Xa in the final common pathway of coagulation. Factor Xa activates prothrombin (factor II) into thrombin (IIa) which converts fibrinogen into fibrin resulting in clot formation. Proteins C and S are vitamin K-dependent inhibiting enzymes involved in regulating the coagulation process. Protein S serves as a cofactor for protein C which is converted to activated protein C (APC). APC is a serine protease which inactivates factors Va and VIIIa, limiting thrombotic formation.
Onset: rapid
Duration: 6-8 hours
Half-life: Factor II: 48 to 60 hours; Factor VII: 1.5 to 6 hours; Factor IX: 20 to 24 hours; Factor X: 24 to 48 hours; Protein C: 1.5 to 6 hours; Protein S: 24 to 48 hours