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Argatroban
See also Direct thrombin inhibitors
General information
Argatroban is a direct thrombin inhibitor that has been used to treat thrombosis in patients with heparin-induced thrombocytopenia [ ] or heparin allergy [ ]. However, in some patients overanticoagulation has occurred and care with dosage is clearly required [ ].
Its effects can be monitored using the activated partial thromboplastin time for low doses and the activated clotting time for high doses. Its pharmacology, clinical pharmacology, and uses have been reviewed [ ].
Drug studies
Comparative studies
Argatroban has been used in 13 patients who developed heparin-induced thrombocytopenia after exposure to heparin 10 000–13 000 units from an intravascular catheter or filter flush, with a mean exposure of 8 days [ ]. They were compared with 10 historical controls who had received no direct thrombin inhibitors. The platelet count recovered to a mean of 207 × 10 9 /l (n = 12) after 5.5 days of argatroban therapy and to a mean of 127 × 10 9 /l (n = 8) 5 days after baseline in the control group. A composite end point of death, amputation, or new thrombosis within 37 days occurred in five argatroban-treated patients and four controls. Death was the most common untoward outcome (about 30% in each group). No argatroban-treated patient and two control patients had new episodes of thrombosis. Major bleeding was comparable.
Organs and systems
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