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- Title
Probable pulmonary embolism with repeat administration of prothrombin complex concentrate in a factor Xa inhibitor patient.
- Authors
King, G. S.; Cottingham, L. G.; Hughes, R. E.; Ratliff, P. D.
- Abstract
Summary: What is known and objective: Prothrombin complex concentrate (PCC) is a plasma‐derived concentrate used to replenish clotting factors. There are limited recommendations for treating coagulopathy induced by direct oral anticoagulants (DOAC). Data are limited regarding both total dose and repeated dosing with this population. Case summary: We describe a case of an adult patient anticoagulated with apixaban who received two 35 unit/kg doses of PCC resulting in suspected pulmonary embolism. What is new and conclusion: Treatment of DOAC‐induced bleeding remains an "off‐label" indication for PCC. Additional doses should be given with caution if given at all and patients monitored closely. We present the case of a 67 yo male admitted on chronic anticoagulation with apixaban presenting with hemoptysis. The patient was administered two doses of 4 factor prothrombin complex concentrate (PCC) within a 24 hour period in preparation for bronchoscopy. The hospital course was complicated shortly thereafter with cardiac arrest and suspected pulmonary embolism. Repeat doses of 4 factor PCC should be used with caution.
- Subjects
ANTICOAGULANTS; HEMORRHAGE; PROTHROMBIN; PULMONARY embolism; REOPERATION
- Publication
Journal of Clinical Pharmacy & Therapeutics, 2018, Vol 43, Issue 6, p903
- ISSN
0269-4727
- Publication type
Case Study
- DOI
10.1111/jcpt.12719