Coagulation products and their uses

The indications, pharmacokinetics, and therapeutic guidelines for available coagulation products are reviewed. Patients with hemophilia, von Willebrand's disease (VWD), or acquired inhib itors to antihemophilic factor (AHF) cannot spontaneously stop an acute hem orrhage. Coagulation products used to manage bleeding in patients with these disorde rs include AHF concentrates, factor IX concentrates, factor VIIa concentrat e, factor IX complexes, anti-inhibitor coagulant complexes, and desmopressi n acetate. Typically, these commercially available products are used to man age acute bleeding or to prevent excessive bleeding during surgery. The dos age of the coagulation products and the duration of therapy depend on many variables, including the severity of the hemorrhage, the pharmacokinetics o f the coagulation products, and patient-specific factors. Product purity an d viral attenuation are also important considerations in determining an app ropriate dosage regimen. Recombinant versions of some coagulant factors are available and can eliminate the risk of viral transmission. A thorough understanding of each coagulation product can guide product sele ction, dosing, and treatment duration and can reduce the risk of viral tran smission.