Guest guest Posted January 11, 2011 Report Share Posted January 11, 2011 Dear Members,Argatroban is a small molecule thrombin inhibitor that is FDA-approved for use in patients with Heparin induced thrombocytopenia (HIT) with or without thrombosis and coronary angioplasty in patients with HIT. -It has a short half-life, is given by continuous intravenous infusion, and is monitored by aPTT. -Its clearance is not affected by renal disease but is dependent on liver function; dose reduction is required in patients with liver disease. -Patients on argatroban will demonstrate elevated INRs, rendering the transition to warfarin difficult (ie, the INR will reflect contributions from both warfarin and argatroban). -A nomogram is supplied by the manufacturer to assist in this transition. -No properly designed head-to-head trials have been performed to determine whether argatroban or lepirudin is superior in the treatment of HIT. However, in practice, the choice of which DTI to use in a patient with HIT is usually dictated by the condition of the clearing organ. If the patient has severe renal insufficiency, then argatroban would be preferred. If there is severe hepatic insufficiency, then lepirudin would be a better choice. 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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