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Chapter: Clinical Pharmacology: Anti-infective drugs

Drotrecogin alfa

Recombinant human activated protein C

Recombinant human activated protein C

Recombinant human activated protein C (rhAPC) is a relatively new class of drug possessing antithrombotic, anti-inflammatory, and fibrinolytic properties. Although its mechanism of action isn’t well known, rhACP is used to treat patients with severe sepsis when the risk of death from acute organ dysfunction is extremely high.

 

Drotrecogin alfa

 

Drotrecogin alfa, the first FDA-approved rhACP drug, is used totreat severe sepsis in adult patients with acute organ dysfunction when they are at risk for death.

Pharmacokinetics

 

After I.V. infusion, drotrecogin alfa achieves a median steady state level in 2 hours. Information about its distribution, metabolism, and excretion isn’t available.

Pharmacodynamics

 

Although drotrecogin alfa’s anti-infective action isn’t known, it may work by producing dose-dependent reductions in D-dimer and interleukin-6. Activated protein C exerts an antithrombotic ef-fect by inhibiting factors Va and VIIIa.

Pharmacotherapeutics

 

Drotrecogin alfa is used to treat adults who have severe sepsis as-sociated with acute organ dysfunction and who have a high risk of death. The drug has antithrombotic, anti-inflammatory, and fibri-nolytic properties.

Drug interactions

 

Drotrecogin alfa may interact with another drug that affects he-mostasis, such as an anticoagulant, antiplatelet drug, or throm-bolytic, possibly increasing the risk of bleeding. (See Adverse re-actions to drotrecogin alfa and Contraindications for drotreco-gin alfa.)


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