Heparin-induced thrombocytopenia--therapeutic concentrations of danaparoid, unlike fondaparinux and direct thrombin inhibitors
, inhibit formation of platelet factor 4-heparin complexes.
Direct thrombin inhibitors
(DTIs) DTI Administration Indications Laboratory monitoring Argatroban IV, 2 mg/kg/min Substitute for PTT 1.
The pharmacodynamics and pharmacokinetics of the oral direct thrombin inhibitor
ximelagatran and its active metabolite melagatran: a mini-review.
To what extent do new anticoagulants, such as direct thrombin inhibitors
, affect standard coagulation tests?
Pradaxa, an oral direct thrombin inhibitor
that was discovered and developed by Boehringer Ingelheim, is the first new oral anticoagulant approved in USA in more than 50 years.
Liver function abnormalities, which caused the only previously available oral direct thrombin inhibitor
, ximelagatran, to be denied FDA approval, were infrequent in both groups.
Antman disclosed no relationship with Boehringer Ingelheim, but has relationships with several other drug companies, including a company developing a rival direct thrombin inhibitor
Additional investigations ruled out a coexisting common pathway defect (factor V 144%, factor X 86%, factor II not done), fibrinogen deficiency (fibrinogen, 3700 mg/L, reference interval 1800-4000 mg/L), a direct thrombin inhibitor
(thrombin time, 18.
More recently, the direct thrombin inhibitor
ximelagatran was found to have a benefit similar to that of warfarin but with an unacceptable incidence of hepatotoxicity.
Concerns over the hepatotoxicity risk of the oral direct thrombin inhibitor
ximelagatran swayed a federal advisory panel to recommend against its approval until more data become available.
Effect of melagatran, the active form of the oral direct thrombin inhibitor
, ximelagatran (pINN, formerly H 376/95), on activated partial thromboplastin time in orthopedic surgery patients treated to prevent deep vein thrombosis and pulmonary embolism [Abstract P 3093].
The 18,000-patient Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) study compared the safety and efficacy of two dosages of the direct thrombin inhibitor
dabigatran against warfarin in patients with atrial fibrillation (AF) plus at least one additional risk factor for stroke, including prior stroke, low left ventricular ejection fraction, or age 75 or older.