biology

Prothrombin complex concentrate

Prothrombin complex concentrate is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Prothrombin complex concentrate rather than just read about it. In short: Prothrombin complex concentrate (PCC), also known as factor IX complex, sold under the brand name Kcentra among others, is a combination medication made up of blood clotting factors II, IX, and X(3-factor PCC) or, when also containing factor VII as does Kcentra, 4-factor PCC. It is used to treat and prevent bleeding in hemophilia B if pure factor IX is not available.

Key takeaways

Prothrombin complex concentrate belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Prothrombin complex concentrate to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Prothrombin complex concentrate from memory before moving on to harder problems.

Reference excerpt

Prothrombin complex concentrate (PCC), also known as factor IX complex, sold under the brand name Kcentra among others, is a combination medication made up of blood clotting factors II, IX, and X(3-factor PCC) or, when also containing factor VII as does Kcentra, 4-factor PCC. It is used to treat and prevent bleeding in hemophilia B if pure factor IX is not available. It may also be used for reversal of warfarin therapy. It is given by slow injection into a vein. Another product, activated prothrombin complex concentrate or FEIBA (Factor Eight Inhibitor Bypassing Agent), may be used for acquired hemophilia. Common side effects include allergic reactions, headache, vomiting, and sleepiness. Other serious side effects include blood clots which may result in a heart attack, stroke, pulmonary embolism, or deep vein thrombosis. Antibodies may form after long term use such that future doses are less effective. Prothrombin complex concentrate came into medical use in the 1960s. It is on the World Health Organization's List of Essential Medicines. It is made from human plasma. Recombinant factor IX is also available in a stand-alone preparation.

Medical uses Prothrombin complex concentrate reverses the effects of warfarin and other vitamin K antagonist anti-coagulants and is used in cases of significant bleeding in people with a coagulopathy. It is also used when such a person must undergo an emergency operation. Other uses include a deficiency of one of the included clotting factors, either congenital or due to liver disease, and hemophilia. Several guidelines, including those from the American College of Chest Physicians, recommend prothrombin complex concentrate for warfarin reversal in people with serious bleeding. For rapid anticoagulation reversal for surgery, four-factor prothrombin complex concentrate reduces international normalized ratio (INR) and decreases bleeding during surgery when compared with administration of fresh frozen plasma. No differences in thromboembolic event was found.

Contraindications

The package insert states that prothrombin complex concentrate is contraindicated in patients with disseminated intravascular coagulation, a pathological activation of coagulation, because giving clotting factors would only further fuel this process. However, if the PCC is given because factor levels are low, it can restore normal coagulation. As PCC products contain heparin, they are contraindicated in patients with heparin-induced thrombocytopenia.

Chemistry Prothrombin complex concentrate contains a number of blood clotting factors. Typically this includes factor II, IX, and X. Some versions also contain factor VII, protein C, and protein S. Heparin may be added to stop early activation of the factors.

History The US Food and Drug Administration (FDA) announced its approval in 2013. The FDA approved Kcentra's orphan drug status in December 2012.

Society and culture

Economics In the United States a dose of prothrombin complex concentrate costs about US $3200 though one study described the cost as $11 650. The Australian National Blood Authority sets Prothrombinex (500 IU) at around AUD$327.

Brand names A number of different formulations are available globally.

References

Worked examples

Example 1 — a first encounter with Prothrombin complex concentrate

Start with the simplest possible case. Write down what Prothrombin complex concentrate claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Prothrombin complex concentrate before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Prothrombin complex concentrate ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Prothrombin complex concentrate

In research: Prothrombin complex concentrate appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Prothrombin complex concentrate in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Prothrombin complex concentrate is common in secondary-school and first-year university syllabi. It links to neighbouring topics Blood products, Coagulation system, Orphan drugs, so understanding it makes those chapters shorter.
In everyday life: Look for Prothrombin complex concentrate outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Prothrombin complex concentrate in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Prothrombin complex concentrate means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Prothrombin complex concentrate out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Prothrombin complex concentrate in simple terms?

Why does Prothrombin complex concentrate matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Prothrombin complex concentrate?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Prothrombin complex concentrate.