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Only a few cases of HIT in patients managed by ECMO who developed acute oxygenation failure from thrombosis have been reported in the literature.[6] This condition required an alternative anticoagulation approach such as bivalirudin, argatroban, or rivaroxaban.[7]
If HIT is suspected or confirmed, a direct thrombin inhibitor, such as argatroban or lepirudin, should be considered [23].
By including "if-then" or "and/or/not" statements, alerts for a high INR can be suppressed if the patient is also receiving argatroban, for example, since argatroban is known to falsely elevate INR You may also choose to customize certain alerts for patients who already have increased monitoring, such as those being treated in the ICU.
Argatroban is a synthetic agent derived from L-arginine that selectively and reversibly binds to the thrombin active site, inhibiting its catalytic activity.
Direct thrombin inhibitors (DTIs), such as argatroban, dabigatran, lepirudin, desirudin, and bivalirudin, which bind to thrombin and block its enzymatic activity, are widely and effectively used in the treatment of thromboembolic diseases; however, dabigatran is not orally available due to its high polarity [7].
We decided to begin injection of argatroban hydrate and edaravone, and administered oral aspirin 100 mg.
Despite Bivalirudin (synthetic analogue of hirudin) being 10 times more potent than argatroban, which is a selective antithrombin agent, it cannot be used subcutaneously [30].
In a similar study previously conducted by our group, argatroban (a direct thrombin inhibitor) was able to mask the diagnosis of FVL by raising the APCR ratio into the normal range, (17) and dabigatran (direct thrombin inhibitor) substantially raised the APCR ratio.
La heparina en diferentes modalidades (regional, no fraccionada o de bajo peso molecular), prostaciclinas (epoprostenol), o inhibidores directos de la trombina (argatroban) son algunos ejemplos (2, 11, 13-14)).
Many non-heparin anticoagulants such as argatroban, an FDA-approved direct thrombin inhibitor for treatment and prophylaxis of HIT, possess increased bleeding risk profiles and significant cost disadvantages relative to heparin.
Argatroban was added 8 days after admission because APTT remained below the therapeutic range and warfarin was stopped because of PTINR prolongation.
have shown that the thrombin inhibitor argatroban inhibits both tumor growth and lymphatic metastasis occurrence of breast cancer cells by blocking the formation of OPN thrombin-cleaved fragments [240].
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