Pharmacologic: activated protein C, human
To reduce mortality in adult patients with sepsis.
Probably acts by suppressing widespread inflammation associated with sepsis. Therapeutic Effects: Decrease mortality due to sepsis.
Adverse Reactions/Side Effects
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Use caution with any physical interventions that could increase bleeding, including wound débridement, chest percussion, joint mobilization, and application of local heat.
Instruct patient to immediately report signs of GI bleeding, including abdominal pain, vomiting blood, blood in stools, or black, tarry stools.
Absorption: IV administration results in complete bioavailability.
Metabolism and Excretion: Unknown.
Contraindicated in: Hypersensitivity; Patients with a high risk of bleeding, including those with active internal bleeding, recent (within 3 mo) stroke, recent (within 2 mo) intracranial or intraspinal injury or severe head trauma, any trauma associated with an increased risk of life-threatening bleeding, presence of an epidural catheter, intracranial neoplasm/mass lesion/cerebral herniation; Patients not expected to survive due to preexisting medical condition(s); HIV-positive patients with CD4 cell counts ≤50/mm3; Chronic dialysis patients; Patients who have undergone bone marrow, lung, liver, pancreas, or small bowel transplantation; OB: Lactation.
Use Cautiously in: Concurrent therapeutic heparin therapy (≥15 units/kg/hr), recent (within 3 days) thrombolytic therapy, recent (within 7 days) oral anticoagulants or glycoprotein IIb/IIIa inhibitors, recent (within 7 days) aspirin therapy >650 mg/day or other platelet inhibitors; Platelet count <30,000 × 106/L; Prothrombin time—INR >3; Recent (within 6 wk) GI bleeding; Recent (within 3 mo) ischemic stroke; Intracranial arteriovenous malformation or aneurysm; Known bleeding diathesis; Chronic severe hepatic disease; Any other serious bleeding risk; Surgical procedures (discontinue 2 hr before; resume 12 hr after if hemostasis is achieved); OB: Pregnancy (use only if clearly needed); Pedi: Children (safety not established).
Drug-Drug: Risk of serious bleeding may be ↑ by antiplatelet agents, anticoagulants, thrombolytic agents, or other agents that may affect coagulation.
Drug-Natural: Risk of bleeding may be ↑ by arnica, chamomile, clove, dong quai, feverfew, garlic, ginger, gingko, Panax ginseng, and others.