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Related Concept Videos

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Factors Affecting Protein-Drug Binding: Drug Interactions01:23

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Drug interactions are a critical aspect of pharmacology and can occur when two or more drugs compete for the same binding site. This competition can result in one drug displacing another, altering the effect of the displaced drug. Drug interactions are complex processes that rely heavily on how much of the displacer drug is present and how strongly it can bind to the same sites as the displaced drug.
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Disorders of Hemostasis01:24

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Thromboembolic Disorders
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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Related Experiment Video

Updated: Dec 21, 2025

Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
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When antithrombin substitution strikes back.

Lars Mikael Broman1,2

  • 1ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.

Perfusion
|May 14, 2020
PubMed
Summary
This summary is machine-generated.

Commercially available antithrombin supplements may contain harmful latent antithrombin, a procoagulative residue. This can reduce treatment effectiveness and increase thrombosis risk in critically ill patients.

Keywords:
anticoagulationantithrombinextracorporeal life supportextracorporeal membrane oxygenationheparinlatentprocoagulant

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Area of Science:

  • Biochemistry
  • Hematology
  • Clinical Medicine

Background:

  • Commercially available antithrombin supplements, used in treatments like extracorporeal life support, can contain latent antithrombin.
  • Latent antithrombin is a hyper-stable residue associated with severe thrombosis in critically ill patients.
  • Manufacturing processes involving heat treatment, citrate, and freeze-drying accelerate the conversion of native antithrombin to latent antithrombin.

Purpose of the Study:

  • To raise clinician awareness regarding the potential for reduced efficacy of antithrombin supplementation due to latent antithrombin.
  • To advocate for manufacturers to assess and disclose the latent antithrombin content in their products.

Main Methods:

  • Literature review and analysis of antithrombin product manufacturing processes.
  • Comparison of latent antithrombin levels in commercial products versus healthy individuals.

Main Results:

  • Latent antithrombin fractions in commercial products range from less than 1% to 40%, significantly higher than the <3% found in healthy adults.
  • Current regulations do not mandate the assessment or reporting of latent antithrombin content by manufacturers.

Conclusions:

  • Clinicians should be aware of potential treatment failures with antithrombin supplementation due to latent antithrombin.
  • There is a critical need for manufacturers to implement quality control measures to assess and report latent antithrombin levels.