Thrombin
Class: Hemostatics
CAS Number: 9002-04-4
Brands: Thrombin-JMI
Warning
Use of topical thrombin (bovine) can stimulate antibody formation against bovine thrombin and/or bovine factor V, potentially resulting in severe hemorrhagic or thrombotic complications; rarely fatal. (See Antibody Formation under Cautions.)
Consult expert in coagulation disorders if patient exhibits abnormal coagulation test results, bleeding, or thrombosis. Do not readminister drug to patients with evidence of anti-bovine thrombin antibodies.
Introduction
Hemostatic agent.
Uses for Thrombin
Hemorrhage
Aids hemostasis at accessible sites of oozing blood and minor bleeding from capillaries and small venules. In various types of surgery, may be used in conjunction with an absorbable gelatin sponge.
Does not control arterial bleeding when used alone.
Thrombin Dosage and Administration
General
The concentration of thrombin solutions used depends on the severity of bleeding.
Administration
Topical Administration
Apply topically as a powder or solution; do not inject.
Prepare and administer solution according to manufacturer's recommendations. Use solution promptly upon removal from container.
Spray reconstituted solution directly onto bleeding surfaces (using a sterile syringe and spray tip, spray pump and actuator, or nasal delivery device) or apply with an absorbable gelatin sponge; do not leave solution in syringe as an intermediate step when preparing the spray delivery device.
Alternatively, flood surfaces with thrombin solution using a sterile syringe and small gauge needle. To avoid inadvertent intravascular administration, label syringes containing reconstituted thrombin (bovine) with a warning against IV injection and keep separate from parenteral preparations.
May apply as a dry powder; preferred method of application to oozing surfaces in some cases.
May use in conjunction with a bovine gelatin-based hemostatic matrix (e.g., FloSeal NT).
Before application, sponge (do not wipe) recipient surface free of blood; otherwise, blood may clot on surface layers while bleeding continues underneath clot. After application, avoid sponging treated areas so clot is not disturbed.
When used with an absorbable gelatin sponge, immerse sponge strips of the desired size in the solution and knead vigorously with moistened, gloved fingers to remove trapped air and facilitate saturation. Apply the saturated sponge to the bleeding area and hold in place with a cotton pledget or small gauze sponge until hemostasis occurs. Consult manufacturer's information for detailed instructions on use of absorbable gelatin sponge preparations.
Reconstitution
To prepare a solution containing 1000 units/mL of thrombin (bovine), transfer entire contents of the supplied diluent vial (5 or 20 mL) to a vial containing 5000 or 20,000 units, respectively, of lyophilized thrombin via a syringe or transfer needle. Consult manufacturer's instructions for appropriate us...
