Does Argatroban treat HIT?
Argatroban is an accepted and effective treatment of HIT in patients receiving RRT. Argatroban has also been successfully employed in patients with HIT undergoing percutaneous coronary intervention (PCI).
What is argatroban drip?
Argatroban is a prescription medicine used to treat the symptoms of blood clots in adults (Thrombocytopenia) and Percutaneous Coronary Intervention. Argatroban may be used alone or with other medications.
How is argatroban administered?
Initial Dosage: Initiate an infusion of Argatroban Injection at 25 mcg/kg/min and administer a bolus of 350 mcg/kg via a large bore intravenous line over 3 to 5 minutes (see Table 2). Check an activated clotting time (ACT) 5 to 10 minutes after the bolus dose is completed.
How do you treat hits?
Treatment of HIT entails immediate withdrawal of all heparin, including heparin-containing flushes and catheters. Heparin cessation alone, however, is often insufficient to prevent thrombosis.
Does argatroban affect anti Xa?
Pharmacology of argatroban Argatroban is highly selective for thrombin and has little or no effect on related serine proteases (trypsin, factor Xa, plasmin, and kallikrein).
Is argatroban same as heparin?
Because argatroban does not resemble heparin, it does not cross-react with HIT antibodies,25 a disadvantage of low-molecular-weight heparin and danaparoid. Furthermore, being small and synthetic, argatroban does not induce formation of antibodies that can alter its clearance, a disadvantage of lepirudin.
When do you use argatroban?
Argatroban is used to treat or prevent blood clots in adults who have thrombocytopenia (low levels of platelets in the blood) caused by using heparin. Argatroban is sometimes used in people who are undergoing a procedure called angioplasty (to open blocked arteries).
What kind of drug is argatroban?
Argatroban is a medication used in the management of heparin-induced thrombocytopenia (HIT), which is a rare, life-threatening complication of heparin therapy. It is a direct thrombin inhibitor, a class of anticoagulant drugs.
How do you monitor argatroban?
Argatroban effect is typically monitored using activated partial thromboplastin time (APTT) measurements with a target of 1.5 to 3.0 times the patient’s baseline value.
What is medication for HIT?
Bivalirudin and fondaparinux have been used to treat HIT in small case series. New oral anticoagulants, such as factor IIa and factor Xa inhibitors, may provide a novel treatment approach in HIT. Summary: First-line therapies for HIT are argatroban or lepirudin.
Can HIT be cured?
Treatment of HIT should be initiated based on clinical suspicion and must never be delayed pending laboratory confirmation of HIT. A direct thrombin inhibitor, such as lepirudin, danaparoid or argatroban, is considered the agent of choice for treatment of HIT.
Why is anti-Xa better than PTT?
For several years, most coagulation specialists have supported using the chromogenic anti-Xa assay in place of the PTT for monitoring unfractionated heparin therapy. We contend the anti-Xa is more accurate and reproducible as it is less prone to interference.
When to stop argatroban before surgery?
This means that generally, they can be stopped 1-2 days prior to surgery safely. In patients who are undergoing high-risk surgery, a longer cessation period is preferred (2-3 days, generally). Patients who have abnormal renal function testing should also hold these medications for longer.
Why does argatroban increase INR?
Argatroban raises the INR alone and when administered with warfarin. The goal aPTT for argatroban is 1.5 to 3 times the patient’s individual baseline value. If the patient has hepatic impairment, be sure to adjust the dose of argatroban being used since there is significant variation (see prescribing information)
How to monitor argatroban?
Argatroban is monitored using the activated partial thromboplastin time (aPTT). The goal aPTT in seconds has been defined at UWMC/HMC as 60-80 seconds. Alternatively, it can be monitored with the direct thrombin inhibitor assay available at UWMC/HMC. This assay has a therapeutic range of 60 – 100 seconds for argatroban (different for other DTIs).
What is argatroban used for?
The medicine Argatroban is used to treat Thrombocytopenia