Aprotinin

It is naturally occurring inhibitor of proteolytic enzymes including trypsin, chymotrypsin, kallikrein and plasmin. Inhibition of plasmin inhibits fibrinolysis and reduces operative blood loss.

Indications

Reduction of perioperative blood loss in open heart surgery, management of traumatic haemorrhagic, pancreatogenic and endotoxic shock, acute pancreatitis

Dosage

Reduction of perioperative blood loss in open heart surgery: Loading dose of 2 mio kiu given iv after induction and before sternotomy. Followed by maintenance dose of 500000 KIU/hr by continuous infusion until end of surgery. Then 2 mio KIU added to the priming volume of the extracorporeal circuit. Management of traumatic, haemorrhagic, pancreatogenic and endotoxic shock: 500000 KIU initially followed by 200000 KIU every 4 hrs. Acute pancreatitis (Slow IV): 500000 KIU at 50000 KIU/min. Follow

Contra-Indications

Hypersensitivity, lactation

Special Precautions

Neonates and children, first trimester of pregnancy

Side Effects

Thrombophlebitis. Hypersensitivity or pseudo-allergic reactions after first dose or thereafter.

Drug Interactions

Incompatible with most corticosteroids, nutrient soln containing amino acids and fat emulsions, and tetracyclines. Coadministration with heparin may prolong activated blood clotting time, but dosage of heparin need not be adjusted until risk of thromboses associated with use of aprotinin for surgery have been determined. May block acute response of blood pressure to captopril.