And Now… Amicar ?

Another Questionable Availability Issue…

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I would get on top of this as soon as possible. 

Amicar is a generic yet essential part of life if conducting Cardiopulmonary Bypass.

  1. 1st Protamine
  2. Then Magnesium Sulfate
  3. Now Epsilon Aminocaproic Acid (EACA  aka Amicar)

Is there a common denominator? 

Hospira Inc

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Amicar ® (epsilon-aminocaproic acid)

Amicar ® is the first representative of a family of drugs, the antifibrinolytic agents  The relationship between it’s chemical structure, and its antifibrinolytic action is well established.  It was initially proposed for the treatment of fibrinolysis associated with prostate and cardiac surgery.  A major concern of the administration of Amicar ® is the possibility of excessive coagulation because of impaired fibrinolysis, leading to subsequent tissue or organ ischemia.  (Verstraete, 1985)

Antifibrinolytics bind to plasminogen and plasmin to block fibrinolytic enzymes from binding with lysine residues of fibrinogen  (appendix G).  Excretion occurs renally with concentrations 75-to 100-fold those of plasma.  Plasma half life is approximately 80 minutes (Spiess, 1993).

It is a derivative and analogue of the amino acid lysine, which makes it an effective inhibitor for enzymes that bind that particular residue.

Such enzymes include proteolytic enzymes like plasmin, the enzyme responsible for fibrinolysis.

For this reason it is effective in treatment of certain bleeding disorders – especially fibrogenemia – and is marketed as Amicar.

Aminocaproic acid is also an intermediate in the polymerization of Nylon-6, where it is formed by ring-opening hydrolysis of caprolactam.

Fibrinolysis

Fibrinolysis is the dissolution of the clot formation process involving the plasma protein plasminogen.  This system of enzymes dissolves blood clots by the lysis of fibrin.  Fibrinolysis plays a role as well in other biological processes such as tissue repair, macrophage activation and function, ovulation, and embryo implantation.  Fibrinolysis is mediated by plasmin and during blood coagulation, lysis of fibrin by plasmin results in derivation fragments of fibrin called fibrin degradation products (FDP).

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