Evaluation of the thrombin inhibitor D-phenylalanyl-L-prolyl-L-arginine chloromethylketone (PPACK) with the factor Xa inhibitor 1,5-dansyl-L-glutamyl-L-glycyl-L-arginine chloromethylketone (GGACK) as anticoagulants for critical care clinical chemistry specimens.
The objective of this study was to determine whether a thrombin inhibitor (PPACK) and a factor Xa inhibitor (GGACK) either alone or in combination can anticoagulate whole blood without biasing the analysis of several critical care analytes. Whole blood clot time was used to assess anticoagulant efficacy. The analytical biases mediated by the anticoagulants on glucose, urea, creatinine, electrolytes, amylase, lactate dehydrogenase, creatine kinase, ionized calcium and pH were assessed. The protease inhibitor mixture (100 micrommol/l PPACK + 500 micromol/l GGACK) was more a potent anticoagulant than the individual agents at the same concentrations. Both PPACK and GGACK, alone and in combination, reduced the activity of creatine kinase and amylase by 3-10% while the remaining critical care analytes were less affected. In conclusion, PPACK and GGACK mixtures can effectively anticoagulate whole blood, but the mixtures exert pre-analytical influences that limit the analytical versatility of these novel plasma-matrices.
Lyon
M E
ME
Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada. lyonmar@duke.usask.ca
Drobot
D W
DW
Harding
S R
SR
Lyon
A W
AW
D000590:Amino Acid Chloromethyl Ketones / Q000494:pharmacology*; D000925:Anticoagulants / Q000494:pharmacology*; D000991:Antithrombins / Q000494:pharmacology*; D016477:Artifacts; D003422:Critical Care; D004341:Drug Evaluation; D065427:Factor Xa Inhibitors; D006801:Humans; D013048:Specimen Handling
D000590:Amino Acid Chloromethyl Ketones; D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors; C051330:glutamyl-glycyl-arginine chloromethyl ketone; C040308:phenylalanyl-prolyl-arginine-chloromethyl ketone