Bleeding drotrecogin alfa

HEPARINS DROTRECOGIN ALFA (recombinant activated protein C) t risk of bleeding Drotrecogin alfa 1 prothrombin production and has fibrinolytic/antithrombotic effects Avoid co-administration of drotrecogin alfa with high-dose heparin (>15 lU/kg per hour). Carefully consider the risk-benefit ratio when giving lower doses of heparin... 

ASPIRIN DROTRECOGIN ALFA t risk of bleeding Additive effect on clotting mechanism drotrecogin alfa has antithrombotic and fibrinolytic effects Careful risk-benefit analysis should be undertaken if drotrecogin alfa is given within 7 days of aspirin... 

ASA, NSAIDs, COX-2 seleaive inhibitors, pentoxifylline, drotrecogin alfa, pentosan polysulfate sodium, omega-3-acid ethyl ester can have enhanced antiplatelet efferts and increased bleeding. 

In a retrospective review of the medical records of 73 patients who had received drotrecogin alfa for sepsis, there were serious bleeding events in 7 of 20 with any baseline susceptibility factor for bleeding and only two of 53 patients without more of the former died and they had higher APACHE II scores and more bloodstream infections [15 ]. 

Taylor BJ, Lee SJ, Waxman K. Bleeding complications with drotrecogin alfa activated (Xigris) a retrospective review of 31 operative and 68 non-operative patients with severe sepsis. Am Surg 2008 74(10) 898-901. 

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