Direct thrombin inhibitors

parental drugs:
- Hirudin
- Bivalirudin
- Desirudin
- Argatroban
oral drugs:
- Dabigatran
- Ximelagatran
MOA:
- binds to thrombin directly at its active site
- inhibition of thrombin results in an anticoagulant effect
Indications:
- Postsurgical VTE prophylaxis
- Severe heparin-induced thrombocytopenia (HIT)
CI:
SE:
- CI: pts at high risk for bleeding
- SE: bleeding
Dabigatran indication & dose:
- Prevention of stoke and systemic embolism in patients with A-fib
- 150mg po BID- on exam
Argatroban indication & dose:
- Anticoagulation in patients with A-fib
- Initial dose: 2 mcg/kg/min IV
- Maintenance: adjust dose until the steady-state aPTT is 1.5-3 times the initial baseline value
what is the advantage of direct over indirect thrombin inhibitors (LMWHs)?

they provide more predictable anticoagulation
how do you monitor the anticoagulation of bivalirudin and argatroban?

aPTT

Author

merazar15

228596

Card Set

Direct thrombin inhibitors

Description

pharm-direct thrombin inhibitors

Updated

2013-07-30T13:51:15Z