Andreas Greinacher1, Theodore E. Warkentin2
1Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt Universität Greifswald, Greifswald, Germany; 2Department of Pathology and Molecular Medicine, and Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
This review discusses the pharmacology and clinical applications of hirudin, a bivalent direct thrombin inhibitor (DTI). Besides the current major indication for hirudin – anticoagulation of patients with heparin-induced thrombocytopenia (HIT) – the experience with hirudin in other indications, especially acute coronary syndromes, are briefly presented. Hirudins have been formally studied prior to their regulatory approval; however, important information on their side effects and relevant preventative measures only became available later. Therefore, current recommendations and dosing schedules for hirudin differ considerably from the information given in the package inserts. Drawbacks of hirudin and important precautions for avoiding potential adverse effects are discussed in detail in the third part of this review.
Deep vein thrombosis, hirudin, thrombin, HIT
William P. Sheffield1,2; Louise J. Eltringham-Smith1; Sharon Gataiance1; Varsha Bhakta2
Thromb Haemost 2009 101 5: 867-877
Arina J. ten Cate- Hoek1, 3, Arne W. J. H. Dielis2, Henri M. H. Spronk2, René van Oerle1, Karly Hamulyák1, Martin H. Prins3, Hugo ten Cate2
Thromb Haemost 2008 100 2: 240-245
Rodolphe Meyer1,3, Patrice Degoulet 2,3
IMIA Yearbook 2008 3: 114-127
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