Heparin Substitutes
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Argatroban
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Argatroban is a synthetic direct thrombin inhibitor, a man-made drug that stops, or inhibits, the enzyme thrombin from producing a clot. It is especially useful in treating patients with known heparin-induced thrombocytopenia (low blood platelet count) during cardiopulmonary bypass surgery. Argatroban is not cleared through the liver and works well in patients with renal insufficiency.
Bivalirudin
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Bivalirudin, previously known as hirulog, is a direct thrombin inhibitor. In patients with myocardial infarction -- heart attack caused by the interruption of blood flow to the brain -- bivalirudin reduced the incidence of major hemorrhage, according to a study in the New England Journal of Medicine. When used in patients undergoing fibrinolysis (breaking up a clot), it reduced the incidence of postprocedure myocardial infarction.
Danaparoid Sodium
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Danaparoid is chemically structured like heparin, but requires less patient monitoring than heparin. It has been used during open heart surgeries in patients with heparin-induced thrombocytopenia.
Lepirudin
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Lepirudin is a derivative of hirudin, an anticoagulant found in the saliva of medicinal leeches. It is FDA-approved for treatment of heparin-induced thrombocytopenia. Lepirudin has been used in patients undergoing hemodialysis -- a process of removing waste products from the blood of individuals with kidney disease -- during cardiopulmonary bypass, and also in patients with heparin antibodies.
Warfarin Sodium
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Warfarin sodium is an oral anticoagulant. It is difficult to use because of problems with correct dosing, the need for frequent invasive monitoring, the risk of hemorrhage, and its therapeutic window -- short time interval and concentration at which it is safe.
Warnings
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This information should not be construed as medical advice. Consult your doctor about the need for a heparin substitute.
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