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Ancrod
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Ancrod
Ancrod (current brand name: Viprinex) is a defibrinogenating agent derived from the venom of the Malayan pit viper. Defibrinogenating blood produces an anticoagulant effect. Ancrod is not approved or marketed in any country. It is a thrombin-like serine protease.
As of 2017 ancrod was not marketed for any medical use.
Category X : Ancrod was not found to be teratogenic in animal studies, but some fetal deaths occurred as a result of placental hemorrhages in animals given high doses; therefore, it should not be used during pregnancy as the defibrinogenation mechanism of ancrod might be expected to interfere with the normal implantation of the fertilized egg.
Use of the drug is contraindicated in patients with known bleeding disorders of any origin or with any unexplained excessive bleedings in the past. It should also be avoided in individuals with platelet counts of less than 100,000, even if asymptomatic, with the exception of cases of heparin-induced thrombocytopenia (HIT). Further contraindications include planned surgery or imminent delivery, active ulcerations of the gastrointestinal tract, and any form of malignant disease. The drug is also unsuitable for patients with renal stones, due to the increased likelihood of significant urological bleeding, as well as for those with severe and uncontrolled arterial hypertension, active pulmonary tuberculosis, impaired fibrinolysis, severe liver disease, or manifest or impending shock. In addition, intramuscular administration is not recommended, since I.M. injection of ancrod can rapidly induce neutralizing antibodies and thereby cause drug resistance.
In clinical trials for ischemic stroke, ancrod increased the risk of intracerebral hemorrhage. Hypersensitivity reactions may occur, including local or generalized skin reactions such as rash and urticaria. In some patients, neutralizing antibodies to ancrod appear, leading to partial or total loss of activity and consequent drug resistance. Pain at the injection site is sometimes reported, though it is normally mild and can, if necessary, be treated with local or oral antihistaminic drugs such as clemastine or diphenhydramine. Other injection-related effects include bleeding at the site, thrombophlebitis in local veins, and paradoxical arterial thrombotic events.
Occasionally, deposition of cleaved fibrinogen derivates in the spleen can result in splenomegaly, and strong palpation may lead to rupture, which can cause life-threatening bleeding and necessitate splenectomy. Specific side effects also include local and systemic bleeding events. Local bleeding can be managed with direct pressure or surgical dressings, while the risk of systemic bleeding is relatively low compared with other anticoagulants. If systemic bleeding is severe enough to require rapid reversal of ancrod’s effect, substitution of fibrinogen is recommended (see section on special antidotes).
Other adverse effects reported include increased headache in patients with known migraine, as well as infrequent episodes of chills and fever. Unlike heparin, ancrod has not been associated with thrombocytopenia.
Ancrod has a triple mode of action. It was found that ancrod's actions are FAD dependent and that the substance has interesting apoptotic properties (causing programmed cell death), which remain to be explored.
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Ancrod AI simulator
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Ancrod
Ancrod (current brand name: Viprinex) is a defibrinogenating agent derived from the venom of the Malayan pit viper. Defibrinogenating blood produces an anticoagulant effect. Ancrod is not approved or marketed in any country. It is a thrombin-like serine protease.
As of 2017 ancrod was not marketed for any medical use.
Category X : Ancrod was not found to be teratogenic in animal studies, but some fetal deaths occurred as a result of placental hemorrhages in animals given high doses; therefore, it should not be used during pregnancy as the defibrinogenation mechanism of ancrod might be expected to interfere with the normal implantation of the fertilized egg.
Use of the drug is contraindicated in patients with known bleeding disorders of any origin or with any unexplained excessive bleedings in the past. It should also be avoided in individuals with platelet counts of less than 100,000, even if asymptomatic, with the exception of cases of heparin-induced thrombocytopenia (HIT). Further contraindications include planned surgery or imminent delivery, active ulcerations of the gastrointestinal tract, and any form of malignant disease. The drug is also unsuitable for patients with renal stones, due to the increased likelihood of significant urological bleeding, as well as for those with severe and uncontrolled arterial hypertension, active pulmonary tuberculosis, impaired fibrinolysis, severe liver disease, or manifest or impending shock. In addition, intramuscular administration is not recommended, since I.M. injection of ancrod can rapidly induce neutralizing antibodies and thereby cause drug resistance.
In clinical trials for ischemic stroke, ancrod increased the risk of intracerebral hemorrhage. Hypersensitivity reactions may occur, including local or generalized skin reactions such as rash and urticaria. In some patients, neutralizing antibodies to ancrod appear, leading to partial or total loss of activity and consequent drug resistance. Pain at the injection site is sometimes reported, though it is normally mild and can, if necessary, be treated with local or oral antihistaminic drugs such as clemastine or diphenhydramine. Other injection-related effects include bleeding at the site, thrombophlebitis in local veins, and paradoxical arterial thrombotic events.
Occasionally, deposition of cleaved fibrinogen derivates in the spleen can result in splenomegaly, and strong palpation may lead to rupture, which can cause life-threatening bleeding and necessitate splenectomy. Specific side effects also include local and systemic bleeding events. Local bleeding can be managed with direct pressure or surgical dressings, while the risk of systemic bleeding is relatively low compared with other anticoagulants. If systemic bleeding is severe enough to require rapid reversal of ancrod’s effect, substitution of fibrinogen is recommended (see section on special antidotes).
Other adverse effects reported include increased headache in patients with known migraine, as well as infrequent episodes of chills and fever. Unlike heparin, ancrod has not been associated with thrombocytopenia.
Ancrod has a triple mode of action. It was found that ancrod's actions are FAD dependent and that the substance has interesting apoptotic properties (causing programmed cell death), which remain to be explored.