Aprotinin: a pharmacologic overview.

Orthopedics
Jerrold H Levy, Edward Sypniewski

Abstract

Aprotinin is a polypeptide with serine protease inhibitory activity of key enzymes associated with inflammatory, fibrinolytic, and hemostatic pathways. The drug binds directly to the fibrinolytic plasmin at the lower plasmin-inhibiting dose (plasma concentration, 137 KIU/mL), and the inflammatory mediator, kallikrein, using the higher kallikrein-inhibiting dose (plasma concentration, >250 KIU/mL). Aprotinin inhibits platelet glycoprotein loss (GpIb and GpIIb/IIIa receptors) associated with cardiopulmonary bypass and has been described as platelet sparing. Current literature supports direct anti-inflammatory effects through modulation of neutrophil activation, attachment, and transmigration, with resultant blunting in the rise of proinflammatory cytokine levels and deleterious tissue damaging enzymes. The pharmacologic properties of aprotinin may lead clinicians to consider this therapy for use as a hemostatic and anti-inflammatory agent in surgeries beyond its established use in coronary artery bypass graft surgery.

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Citations

Aug 29, 2007·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Neel R SodhaFrank W Sellke
May 24, 2008·Transfusion·Jerrold H Levy
Aug 21, 2008·Anesthesia and Analgesia·Chinnamuthu MurugesanKanchi Muralidhar
Oct 18, 2011·Anesthesia and Analgesia·Roman M Sniecinski, Wayne L Chandler
Nov 19, 2008·Archives of Toxicology·Josmary BrazónBelsy Guerrero
Mar 23, 2010·Asian Cardiovascular & Thoracic Annals·Yusuke IwataRichard A Jonas
May 26, 2010·Korean journal of anesthesiology·Jin Young LeeSung Jin Hong
Nov 23, 2005·Anesthesia and Analgesia·Toshiya ShigaAtsuhiro Sakamoto
Mar 3, 2006·Expert Review of Cardiovascular Therapy·Neel R SodhaFrank W Sellke
May 24, 2006·Pharmacotherapy·Jeffrey StroupJ Martin Beal

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