Lepirudin (Refludan) (Last Updated - 3/10/2005)

-direct thrombin inhibitor anti-coagulant

-Uses (Approved For):
     -anti-coagulation in pts. w/ Heparin-Induced Thrombocytopenia (HIT) --> low cross-reactivity w/ Heparin

-Admin:
     -given IV
     -daily aPTT monitoring suggested --> maintain aPTT @ 1.5 - 2.5 times normal mean value

-1/2-Life:
     ~1.3 hrs.

-Clearance:
     -renal

-Cautions:
     A) renal dis. --> cleared renally --> levels may accumulate --> increased risk of bleeding
     B) pts. may develop anti-hirudin Ab's --> may see paradoxically shorter aPTT

-NO antidote

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References:

Goodman & Gilman's: The Pharmacologic Basis Of Therapeutics - 10th Edition - 2001. Chapter 55.