Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.6 (thromboplastin)
 13,278 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten percent pentastarch is a low-molecular-weight hydroxyethyl starch with greater oncotic pressure and shorter intravascular persistence than 6% hetastarch. To evaluate its safety and efficacy as a component of cardiopulmonary bypass priming solution, we prospectively studied 90 patients undergoing coronary artery bypass grafting or valve replacement necessitating cardiopulmonary bypass (bubble oxygenator and moderate systemic hypothermia). Sixty patients were randomized to receive 75 gm of either 10% pentastarch (group P) or 25% albumin (group A), and 30 patients received lactated Ringer's solution alone (group C). Intravascular colloid osmotic pressure during cardiopulmonary bypass was highest with either of the colloid primes (15-minute measurement: group P, 15.7 +/- 2.2 mm Hg (mean +/- standard deviation); group A, 15.2 +/- 2.0 mm Hg; group C, 11.3 +/- 1.7 mm Hg; p less than 0.05, groups P and A compared with group C). This was associated with a lower volume requirement during cardiopulmonary bypass to maintain the venous reservoir (group P, 333 +/- 318 ml; group A, 483 +/- 472 ml; group C, 1332 +/- 1013 ml; p less than 0.05, groups P and A compared with group C). Urine output during cardiopulmonary bypass was similar in each group. Net intraoperative fluid balance was lowest in the colloid groups (groups P and A, 5.7 +/- 1.4 L; group C, 6.9 +/- 1.3 L; p less than 0.05, groups P and A compared with group C). Cardiac index shortly after weaning from cardiopulmonary bypass was greatest in group P (group P, 3.2 +/- 0.9; group A, 2.8 +/- 0.8; group C, 2.7 +/- 0.6 dyne.sec.cm-5; p less than 0.05, group P compared with group C). Changes in alveolar-arterial oxygen gradients, shunt fraction, and effective compliance were similar in all groups. During cardiopulmonary bypass, pentastarch appeared to cause the greatest degree of hemodilution, as suggested by the lowest hemoglobin, factor VII and IX levels and platelet count. The activated partial thromboplastin time was significantly prolonged during and immediately after cardiopulmonary bypass in group P relative to groups A and C (p less than 0.05), although there were no significant differences in the activated clotting time before cardiopulmonary bypass, during cardiopulmonary bypass, or after heparin neutralization. As well, clinical indices of hemostasis, including mediastinal drainage, red cell, platelet, and fresh frozen plasma requirements, and reoperation for excessive postoperative bleeding, were similar. We conclude that pentastarch, when used in cardiopulmonary bypass prime, is as safe as either albumin or Ringer's solution alone.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The safety and efficacy of ten percent pentastarch as a cardiopulmonary bypass priming solution. A randomized clinical trial. 137 60

Antithrombin III (CAS 52014-67-2) is produced from plasma of healthy donors and is purified from any detectable agent of transmissible infection. This drug is used in therapy by i.v. route to manage acute thrombotic episodes and to treat patients suffering from its deficiency. The present trial was conducted with the aim to evaluate the pharmacokinetics and the safety of a new preparation of antithrombin III, which in the purification procedure has included a nanofiltration step to increase the safety against the transmission of any agent of infection. The trial was conducted in twelve healthy volunteers of either sex. All the ethics procedures were fully respected, namely the approval from Ethics Committee, the notification to the central regulatory authority, the approval of consent form in writing. Volunteers were hospitalized about 36 h before drug treatment. The baseline situation was investigated throughout the day before the treatment (day-1). On day 1, the drug was infused i.v. for 20 min. Twenty blood samples were drawn from each volunteer, in baseline situation, during and after the infusion. Functional antithrombin III, antithrombin III antigen, prothrombin time, partial thromboplastin time were evaluated in all plasma samples. Both functional antithrombin III and antithrombin III antigen produced well defined plasma concentration-time profiles after the infusion, which allowed net values of these two analytes to be obtained subtracting baseline from post-infusion concentrations. Net pharmacokinetic parameters of functional antithrombin III and antithrombin III antigen proved to be almost superimposable. A comparison of data obtained in this trial on healthy volunteers with those previously obtained by other authors on target population demonstrates similar and fully comparable results. The authors conclude that the nanofiltration step neither affects at all the pharmacokinetics/pharmacodynamics nor the safety of the formulation investigated.
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PMID:Pharmacokinetic behaviour of antithrombin III following intravenous infusion in healthy volunteers. 1196 46