Guest guest Posted January 11, 2011 Report Share Posted January 11, 2011 Dear members, Leeches have been used for bloodletting since the age of Hippocrates. More recently, surgeons have used medicinal leeches (Hirudo medicinalis) to prevent thrombosis in the fine vessels of reattached digits. Hirudin is a specific, irreversible thrombin inhibitor from leech saliva that is now available in recombinant form as lepirudin. -Its action is independent of antithrombin, which means it can reach and inactivate fibrin-bound thrombin in thrombi. -Lepirudin has little effect on platelets or the bleeding time. Like heparin, it must be administered parenterally and is monitored by the aPTT. -Lepirudin is approved by the FDA for use in patients with thrombosis related to heparin-induced thrombocytopenia. -Lepirudin is excreted by the kidney and should be used with great caution in patients with renal insufficiency as no antidote exists. -Up to 40% of patients who receive long-term infusions develop an antibody directed against the thrombin-lepirudin complex. These antigen-antibody complexes are not cleared by the kidney and may result in an enhanced anticoagulant effect. Some patients re-exposed to the drug have developed life-threatening anaphylactic reactions. Regards,Dr. Vijaya Chaudhari.JR-3,Dept. of Pharmacology,Government Medical College, Nagpur. Quote Link to comment Share on other sites More sharing options...
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