Drotrecogin alfa

Drotrecogin alfa may be utilized for patients at a high risk of mortality, and is not utilized for patients at a low risk of mortality (as defined by APACHE II scores). 

Patients predicted to follow a severe course require treatment of any cardiovascular, respiratory, renal, and metabolic complications. Aggressive fluid resuscitation is essential to correct intravascular volume depletion and maintain blood pressure. IV colloids may be required because fluid losses are rich in protein. Drotrecogin alfa may benefit patients with pancreatitis and systemic inflammatory response syndrome. IV potassium, calcium, and magnesium are used to correct deficiency states. Insulin is used to treat hyperglycemia. Patients with necrotizing pancreatitis may require antibiotics and surgical intervention. 

Cilostazol (Pletal) Drotrecogin Alfa (Xigris) Eculizumab (Soliris) Lanthanum Carbonate (Fosrenol)... 

A. General description Drotrecogin alfa (activated) is a recombinant form of human Activated Protein C. An established... 

Drotrecogin alfa (acitvated), human recominant of activated protein C... 

Adjunctive immunomodulatory drugs such as drotrecogin-alfa can also be considered for patients with severe sepsis. 

Xigris Drotrecogin alfa Eli Lilly 11/2001 Severe sepsis NA... 

Antithrombotic agents alteplase, drotrecogin alfa, antithrombin III Antianemic darbopoetin alfa, erythropoietin Growth hormones follitropin alpha, follitropin beta, chorionic gonadotropin (Human)... 

In a phase III trial, hallucinations occurred in 1.1% of patients treated with drotrecogin alfa versus 0.1% in the placebo group (27). 

Olsen KM, Martin SJ. Pharmacokinetics and clinical use of drotrecogin alfa (activated) in patients with severe sepsis. Pharmacotherapy 2002 22(12 Pt 2) S196-205. 

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... 

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... 

In a phase III trial of drotrecogin alfa, hypertension (2.6 versus 0.6% with placebo) was one of the most frequent adverse effects (6). 

Drotrecogin alfa should be used with care in patients receiving heparin, thrombolytic drugs, oral anticoagulants, glycoprotein Ilb-IIIa inhibitors, and aspirin or other antiplatelet drugs (6). 

In two of 370 patients treated with drotrecogin alfa during a phase III trial, antibodies to activated protein C were found, but these were not inhibitory no cases of neutralizing antibodies have been found (7). 

Because activated drotrecogin alfa reduces inflammation, it is theoretically possible that there is an increased risk of infection. However, a phase III trial did not show an increased rate of infection in the drotrecogin alfa-treated patients compared with placebo (6). 

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