| |
Argatroban;
What is it for? | Direct thrombin inhibitor;
Used to tx HIT |
HIT
How is it formed? | Heparin-Induced Thrombocytopenia
Immune-mediated rxn--> IgG atbx directed at heparin-platelet factor 4 --> excessive thrombin generation in response to sig. reduction in platelets due to heparin |
Heparin-induced osteoporosis;
Incidence occurence? (2 parts to answer) | Heparin binds to osteoblasts;
rare; only occurs w/ infusions >6 |
Adverse effects of UFH; how to tx? | Bleeding & HIT & heparin-induced osteoporosis |
How to tx UFH-induced bleeding? | Tx with IV bolus of protamine sulfate (1 mg neutralizes 100 units of UFH) |
Bivalirudin;
What is it for? | Direct thrombin inhibitor;
Used to tx HIT |
What is used to tx HIT? | Argatroban, Bivalirudin, & Fondaparinux |
___% of LMWH molecules inactivate thrombin? | 25-50% |
Compare UFH's and LMWH's molecular weight | LMWH is 1/3 the molecular weight of UFH |
UFH VTE tx dosing | 80 mg IV bolus + 18mg/kg IV continuous infusion |
UFH VTE prophylaxis dosing | 5000 Units SC q8h |
LMWH (enoxaparin) VTE tx dosing | 1 mg/kg SC q12h OR 1.5 mg/kg q24h;
renal adjustment: 1 mg/kg SC q24h (CrCl<30mL/min) |