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Manufacturers:Bayer Germany, Miles Inc.
Brand Names:Trasylol

Aprotinin is a medication used to control bleeding during surgery. It is effective in a wide variety of surgeries but is most effective in heart surgeries and orthopedic procedures.

Aprotinin is a natural proteinase inhibitor obtained from bovine lung. Aprotinin (molecular weight of 6512 daltons) consists of 58 amino acid residues that are arranged in a single polypeptide chain, cross-linked by three disulfide bridges. It is supplied as a clear, colorless, sterile isotonic solution for intravenous administration. Each milliliter contains 10,000 KIU (Kallikrein Inhibitor Units) (1.4 mg/ml) and 9 mg sodium chloride in water for injection. Hydrochloric acid and/or sodium hydroxide is used to adjust the pH to 4.5-6.5.

Aprotinin is a proteinase inhibitor with a variety of effects on the coagulation system. It inhibits plasmin and kallikrein,thus directly affecting fibrinolysis. It also inhibits the contact phase activation of coagulation and promotes fibrinolysis.

In addition to these effects on the clotting and lysis cascades in blood, aprotinin preserves the adhesive glycoproteins in the platelet membrane making them resistant to damage from the increased plasmin levels and mechanical injury that occur during cardiopulmonary bypass. The net effect is to inhibit both fibrinolysis and turnover of coagulation factors, and to decrease bleeding.

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