How do I monitor for possible systemic activation of coagulation?
  Clinical studies of recombinant Factor VIIa have not demonstrated significant systemic activation of coagulation. Levels of functional fibrinogen and antithrombin do not change during repeated injections of recombinant Factor VIIa for the treatment of hemorrhage. The minimal changes that occur postoperatively are not greater than those seen with patients who do not have coagulation disorders. Nonetheless, it is still advisable to monitor patients at risk of systemic activation. Typical pathological conditions that may increase the risk of thrombosis are infections and septicemia (when monocytes may express high levels of TF). Also multiple trauma or major orthopedic surgery may precipitate the risk of thrombotic complications during recombinant Factor VIIa treatment, although this has not been reported.
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