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.