factor IX complex

complex

 [kom´pleks]

1. the sum, combination, or collection of various things or related factors, like or unlike; e.g., a complex of symptoms (see syndrome).

2. a group of interrelated ideas, mainly unconscious, that have a common emotional tone and strongly influence a person's attitudes and behavior.

3. that portion of an electrocardiographic tracing which represents the systole of an atrium or ventricle.

AIDS-related complex (ARC) a complex of signs and symptoms occurring in HIV infection including fever, weight loss, prolonged diarrhea, minor opportunistic infections, lymphadenopathy, and changes in cells of the immune system.

antigen-antibody complex here the complex formed by the noncovalent binding of an antibody and antigen. Complexes of antibodies belonging to certain immunoglobulin classes may activate complement. Called also immune complex.

anti-inhibitor coagulant complex (AICC) a concentrated fraction from pooled human plasma, which includes various coagulation factors. It is administered intravenously as an antihemorrhagic in hemophilic patients with inhibitors to coagulation factor VIII.

atrial complex the P wave of the electrocardiogram, representing electrical activity of the atria. See also ventricular complex.

castration complex in psychoanalytic theory, unconscious thoughts and motives stemming from fear of loss of the genitals as punishment for forbidden sexual desires.

Electra complex libidinous fixation of a daughter toward her father. This term is rarely used, since oedipus complex is generally applied to both sexes.

factor IX complex a sterile, freeze-dried powder consisting of partially purified coagulation factor IX fraction, as well as concentrated factor II, VII, and X fractions, of venous plasma from healthy human donors. It is used in the prophylaxis and treatment of bleeding in patients with hemophilia B, replacement of factor VII in patients deficient in that factor, and treatment of anticoagulant-induced hemorrhage. Administered intravenously.

Ghon complex primary complex (def. 1).

Golgi complex golgi apparatus.

HLA complex the human major histocompatibility complex, which contains the hla antigens.

immune complex antigen-antibody complex.

inclusion complex one in which molecules of one type are enclosed within cavities in the crystalline lattice of another substance.

inferiority complex unconscious feelings of inadequacy, producing shyness or timidity or, as a compensation, exaggerated agressiveness and expression of superiority; based on Alfred Adler's concept that everyone is born with a feeling of inferiority stemming from real or imagined physical or psychological deficiency, with the manner in which the inferiority is handled determining behavior.

interpolated premature ventricular complex a premature ventricular complex that does not interfere with the conduction of the next sinus beat, i.e., it lacks the usual following compensatory pause.

major histocompatibility complex (MHC) the chromosomal region containing genes that control the histocompatibility antigens; in humans it controls the hla antigens.

membrane attack complex (MAC) C5b,6,7,8,9, the five-molecule complex that is the cytolytic agent of the complement system.

Oedipus complex see oedipus complex.

primary complex

1. the combination of a parenchymal pulmonary lesion (Ghon focus) and a corresponding lymph node focus, occurring in primary tuberculosis, usually in children. Similar lesions may also be associated with other mycobacterial infections and with fungal infections.

2. the primary cutaneous lesion at the site of infection in the skin, e.g., chancre in syphilis and tuberculous chancre.

QRS complex a group of waves seen on an electrocardiogram, representing ventricular depolarization. Called also QRS wave. It actually consists of three distinct waves created by the passage of the cardiac electrical impulse through the ventricles and occurs at the beginning of each ventricular contraction. In a normal surface electrocardiogram the R wave is the upward deflection; the first downward deflection represents a Q wave and the final downward deflection is the S wave. The Q and S waves may be extremely weak and sometimes are absent.

One abnormality of the QRS complex is increased voltage resulting from enlargement of heart muscle, which produces increased quantities of electric current. A low-voltage QRS complex may result from toxic conditions of the heart, most commonly from fluid in the pericardium. Pleural effusion and emphysema also can cause a decrease in the voltage of the QRS complex.

VATER complex an association of congenital anomalies consisting of vertebral defects, imperforate anus, tracheoesophageal fistula, and radial and renal dysplasia.

ventricular complex the Q, R, S, and T waves of the electrocardiogram, representing ventricular electrical activity. See also atrial complex.

factor IX (human)

AlphaNine SD, Immune VH (CA), Mononine

factor IX (recombinant)

BeneFix

factor IX complex

Bebulin VH, Defix (UK), Hipfix (UK), Octaplex (CA), Profilnine SD, Proplex T (heat-treated), Replenine (UK)

Pharmacologic class: Blood modifier

Therapeutic class: Antihemophilic

Pregnancy risk category C

Action

Converts fibrinogen to fibrin, increasing levels of clotting factors

Availability

Powder for injection: Various strengths; units specified on label

Indications and dosages

➣ Factor IX deficiency (hemophilia B or Christmas disease); anticoagulant overdose

Adults and children: Dosage individualized; drug administered I.V. Use following equations to calculate approximate units needed:

Human product-1 unit/kg times body weight (in kg) times desired increase in factor IX level, expressed as percentage of normal

Recombinant product-1.2 units/kg times body weight (in kg) times desired increase in factor IX level, expressed as percentage of normal

Proplex T-0.5 unit/kg times body weight (in kg) times desired increase in factor IX level, expressed as percentage of normal

Off-label uses

• Hepatic dysfunction

• Esophagitis

• Unspecified GI hemorrhage (human product)

Contraindications

• Hypersensitivity to mouse or hamster protein (with BeneFix)

• Fibrinolysis

Precautions

Use cautiously in:

• recent surgery

• pregnant patients

• children younger than age 6 (safety and efficacy not established).

Administration

☞ Give by slow I.V. infusion. Average infusion rate is 100 units (2 to 3 ml)/minute; don't exceed 10 ml/minute.

• If prescribed, administer hepatitis B vaccine before giving factor IX.

• Know that dosage is highly individualized according to degree of factor IX deficiency, patient's weight, and bleeding severity.

• Don't use glass syringe. Don't shake reconstituted solution or mix with other I.V. solutions.

Adverse reactions

CNS: light-headedness, paresthesia, headache

CV: blood pressure changes, thromboembolic reactions, myocardial infarction (MI)

EENT: allergic rhinitis

GI: nausea, vomiting

Hematologic: disseminated intravascular coagulation (DIC)

Respiratory: pulmonary embolism

Skin: rash, flushing, diaphoresis, pruritus, urticaria

Other: altered taste, fever, chills, burning sensation in jaw and skull, pain at I.V. injection site, hypersensitivity reactions including anaphylaxis

Interactions

Drug-drug. Aminocaproic acid: increased risk of thrombosis

Patient monitoring

• Be aware that factor IX complex may transmit hepatitis.

• Closely monitor vital signs during infusion.

☞ Observe for hemolytic reaction. If it occurs, stop infusion, flush line with saline solution, and notify prescriber immediately.

• Monitor I.V. injection site closely.

☞ Monitor coagulation studies closely. Know that drug may cause thromboembolic disorders, including MI and DIC.

Patient teaching

• Inform patient that drug may transmit diseases.

☞ Tell patient to immediately report signs and symptoms of hypersensitivity reaction, including rash, hives, tightness in chest, wheezing, shortness of breath, and swelling of throat or lips.

☞ Advise patient to immediately report unusual bleeding or bruising.

• Caution patient to avoid activities that can cause injury.

• Tell patient to wear medical identification stating that he has a blood-clotting disorder.

• Instruct patient to notify surgeon or dentist of his blood-clotting disorder before surgery or invasive dental procedures.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.

fac·tor IX com·plex

(fak'tŏr kom'pleks)

A hemostatic containing factors II, VII, IX, and X.