fibrinogen, human

Action and Spectrum

Actions and Spectrum: 

fibrinogen is a soluble plasma protein synthesized in the liver and circulates in the blood. It plays a crucial role in blood clotting, also known as hemostasis. 

When tissue damage occurs, various components of the blood coagulation cascade are activated. fibrinogen is converted to its active form, fibrin, by the action of the enzyme thrombin, which is produced as a result of the cascade. Fibrin forms a mesh-like structure that reinforces the platelet plug at the injury site, stabilizing the clot and preventing further blood loss. 

The action of fibrinogen is, therefore, to contribute to the formation of blood clots, an essential physiological process in response to injury or trauma. However, excessive clotting can also harm and lead to deep vein thrombosis, pulmonary embolism, and stroke. 

Apart from its role in blood clotting, fibrinogen has been shown to play the main role in other physiological processes, such as inflammation, wound healing, and angiogenesis. It can also interact with other proteins and cells, such as integrins, to influence cell adhesion and migration. 

The spectrum of fibrinogen refers to the different forms or isoforms of the protein that can be produced due to the alternative splicing of the fibrinogen gene. These isoforms can differ in their functional properties and susceptibility to proteolytic cleavage by enzymes such as thrombin. Specific isoforms of fibrinogen have been associated with an enhanced risk of cardiovascular disease, stroke, and other conditions. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Arterial thrombosis 

Allergic reactions 

Nausea 

DVT 

Headache 

Vomiting 

Chills 

Pulmonary embolism 

Thrombocytosis 

Dyspnea 

Fever 

Thromboembolism 

Rash 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindication 

fibrinogen is not a drug and does not have formal contraindications. However, there are situations where using fibrinogen-containing products, such as fibrin sealants or fibrin glue, may not be appropriate. Some possible considerations are: 

• Allergy or hypersensitivity: Individuals with a known allergy or hypersensitivity to fibrinogen or any other components of fibrin-containing products should not use them. 
• Bleeding disorders: fibrinogen-containing products promote clotting, so they may not be appropriate for individuals with bleeding disorders or at an increased risk of bleeding. 
• Active infections: Fibrin sealants and fibrin glue products may not be appropriate for individuals with active infections at the intended use site. 
• Use in certain body areas: The use of fibrin sealants or fibrin glue products may not be appropriate for specific body areas, such as the brain or spinal cord, due to the risk of complications. 
• Pre-existing medical conditions: fibrinogen-containing products may need to be carefully considered in individuals with pre-existing medical conditions, such as cardiovascular disease, due to the potential for associated risks. 

Caution 

While fibrinogen itself is not a drug and does not have specific cautions, using fibrinogen-containing products such as fibrin sealants or fibrin glue may require caution and careful consideration in certain circumstances. Some possible cautions include: 

• Hemostasis: While fibrinogen plays a crucial role in hemostasis, the use of fibrin sealants or fibrin glue may require careful consideration in individuals with pre-existing hemostatic disorders, such as hemophilia because it may interfere with their clotting ability. 
• Infection: The use of fibrin sealants or fibrin glue should be avoided in areas of active infection or inflammation as it may increase the risk of infection. 
• Compatibility: fibrinogen-containing products may not be compatible with certain drugs or devices used during the procedure, such as anticoagulants or catheters. This should be carefully evaluated before use. 
• Quality control: Using fibrinogen-containing products requires strict quality control measures to ensure that the products are free from pathogens and meet regulatory standards. 
• Adverse reactions: While adverse reactions to fibrin sealants or fibrin glue are rare, they can occur, and healthcare providers should be prepared to manage any potential complications. 

Pregnancy / Lactation

Pregnancy consideration:  

US FDA pregnancy category: C 

Lactation:   

Excreted into human milk is Not known. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.        
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women        
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.       
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.        
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.        
• Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

fibrinogen is not a medication but a naturally occurring protein in the blood that plays a crucial role in the coagulation (clotting) process. When a blood vessel is injured, fibrinogen is converted to its active form, fibrin by the enzyme thrombin, which forms a fibrin clot that helps to stop bleeding and promote wound healing. 

fibrinogen has a high molecular weight and is a large, complex protein with multiple domains. It is synthesized in the liver and is present in the blood plasma at concentrations of approximately 2-4 g/L. fibrinogen is a vital component of the coagulation cascade and interacts with other proteins, such as thrombin, factor XIII, and von Willebrand factor, to form a stable fibrin clot. 

In medical and surgical procedures, fibrinogen-containing products such as fibrin sealants or fibrin glue promote hemostasis or tissue sealing. These products typically contain both fibrinogen and thrombin, as well as other components such as calcium or aprotinin, which can help to stabilize the fibrin clot and prevent degradation. 

Pharmacodynamics: 

Mechanism of action: The action of fibrinogen concentrate in patients with congenital fibrinogen deficiency involves the replacement of the missing fibrinogen protein. The concentrate is pooled from human plasma and is a replacement therapy for patients with this inherited disorder. By administering fibrinogen concentrate, the missing protein is replenished, which helps to promote blood clotting and prevent bleeding complications. 

Pharmacokinetics: 

Absorption 

When fibrinogen-containing products are applied topically, the fibrinogen and other components are absorbed into the bloodstream through the surrounding tissue. The rate, extent of absorption depends on the specific product and administration technique used. 

Distribution 

Once absorbed into the bloodstream, fibrinogen is distributed throughout the body via the circulatory system. fibrinogen is a large protein with a high molecular weight, which means it may not be able to pass through the blood-brain barrier or other tissues with tight junctions. 

Metabolism 

fibrinogen is metabolized in the liver, where it is synthesized. The average half-life of fibrinogen in the blood is approximately 3-5 days. Fibrinogen-containing products can be metabolized in a similar manner as endogenous fibrinogen. 

Elimination and Excretion 

fibrinogen and fibrin-containing products are not typically excreted from the body in a traditional sense, as they are metabolized and broken down in the liver. However, unused or excess products may be cleared from the body via the kidneys or excreted in the urine. 

Adminstartion

Administration: 

As a natural protein, fibrinogen is not typically administered as a medication. However, fibrinogen-containing products such as fibrin sealants or glue are administered during surgical or medical procedures to promote hemostasis or tissue sealing. 

The specific administration technique may vary depending on the product being used and the intended use. Generally, fibrin sealants or fibrin glue are administered topically, applying them directly to the tissue or wound site. They are typically supplied as two components: one component contains the fibrinogen, and the other contains thrombin and calcium. The components are mixed immediately before use to form a fibrin clot. 

The healthcare provider will determine the appropriate amount and location of the fibrin sealant or fibrin glue based on the patient’s circumstances and intended use. Careful attention should be paid to the instructions for use and the sterile technique to minimize the risk of infection. 

Healthcare providers must monitor the patient closely after administering fibrin sealants or fibrin glue to ensure adequate hemostasis or tissue sealing and to watch for potential adverse reactions. Patients should be informed about the benefits and risks of the fibrinogen-containing product and any post-procedure care that may be necessary. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: fibrinogen, human 

Why do we use fibrinogen human? 

fibrinogen is a naturally occurring protein in the blood that plays a crucial role in coagulation (clotting). While fibrinogen is not a medication, fibrinogen-containing products such as fibrin sealants or fibrin glue are used in medical and surgical procedures for their hemostatic and tissue-sealing properties. 

Some specific uses of fibrinogen-containing products include: 

• Hemostasis: Fibrin sealants and fibrin glue can be used to promote hemostasis or stop bleeding during surgical or medical procedures. They are instrumental in surgeries involving highly vascular tissues or areas where traditional sutures may be difficult to place. 
• Tissue sealing: Fibrin sealants and fibrin glue can seal tissues or organs during surgery, such as in liver resections or lung surgery. They can be used to seal minor wounds or lacerations. 
• Wound healing: Fibrin sealants and fibrin glue can promote wound healing process by facilitating the formation of a fibrin clot, which can help stabilize the wound and prevent infection. 
• Tissue engineering: fibrinogen-containing products have also been investigated for their potential use in tissue engineering applications, such as artificial skin or cartilage development.