Coagulation factor concentrates-
The risk of apotential interaction between coagulation factor VIIa  were thrombotic reactions.but
the extent of  the extent of risk of interactions is considered low.

Bleeding episodes

Common adverse reactions-

Arthalgia, edema, headache, hemorrhage , hypertension, hypotension, injection site reactions,
nausea, pain, pyrexia, rash and vomiting

Special Precautions-

Thrombotic reactions- the extent of risk of arterial and venous thromboembolic adverse reactions
after treatment with coagulation Factor VIIa  in patients without hemophilia  is not known.
Safety and efectiveness have not  been established.

Prolonged administration- excercise caution when coagulation factor VIIa  is used for prolonged
dosing

Concomittant use with other formulations- concomittant use of caoagulation factor VIIa with other
formulation is not known.

Hypersensitivity- administer coagulation factor VIIa with caution in patients with known
hypersensitivity to the drug or any other components or in patients with known hypersensitivity

Pregnancy- use coagulation factor VIIa during pregnancy only if the potential benefits justifies
the potential risk to the fetus.

Lactation-  decide whether to discontinue breast feeding or the drug taking into consideration  the
importance of the drug to the mother.

Monitoring- Monitor deficient patient to PT and factor VII coagulant activity before and after
administeration. If PT is not corrected, or bleeding is not controlled after treatment with the
 recommended doses, suspect antibody formation and perform analysis for antibodies
 

Indication-
Bleeding episodes

Dosage-
90mcg/kg every 2 hours by slow bolus infusion until hemostatsis is acheived or until the treatment
has been judged to be inadequate .

Doses between 35 and 120mcg/kg have been used successfully in  clinical trials for Hemophilia
A or B patients with inhibitors to factor VIII or factor IX, and both the dose dose and the degree of
hemostatis acheived.

1. Inform patients receiving coagulation Factor VIIa of the benefits and risks associted with the
    treatment

2. Warn patients about the early signs of hypersensivity  reactions, including anaphylaxis, hives,
    hypotension, tightness of the chest, urticaria, and wheezing.

3. Although bleeding can cause similar symptoms, warn patients about the signs of altered
    consiciosness or speech , loss of sensation or motor power, new onset of chest pain,
   new onset of swelling and pain in the limbs, or abdomen, or shortness of breath.

Pharmacology-
Recombinant Factor VIIa  when complexed with tissue  factor can activate coagulation factor X
 to factor Xa, as well as coagulation factor IX  to factor IXa.

 Factor Xa a complex with other factors then converts prpthrombin to thrombin, which leads to
the formation of hemostatic plug by converting fibronogen to fibrin and therby inducing local
hemostasis.

Pregnancy-
Use coagulation factor VIIa during pregnancy only if the potential benefits justifies
the potential risk to the fetus.

Lactation- 
Decide whether to discontinue breast feeding or the drug taking into consideration  the
importance of the drug to the mother.