PMID- 11302409
OWN - NLM
STAT- MEDLINE
DCOM- 20010802
LR  - 20201208
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 35
IP  - 4
DP  - 2001 Apr
TI  - Argatroban for prevention and treatment of thromboembolism in heparin-induced 
      thrombocytopenia.
PG  - 440-51
AB  - OBJECTIVE: To renew the pharmacology, pharmacokinetics, efficacy adverse events, 
      and cost of argatroban in the prevention and treatment of thromboembolism in 
      patients with heparin-induced thrombocytopenia (HIT). DATA SOURCES: A MEDLINE 
      search (1980 to August 2000) of English-language literature was conducted using 
      the search term argatroban to identify pertinent case reports, clinical trials, 
      abstracts, and review articles. Additional reports were identified from the 
      reference lists compiled in the literature reviewed, as well as from the 
      manufacturer. DATA SYNTHESIS: Argatroban is a synthetic direct thrombin inhibitor 
      indicated for parenteral use in the prevention and treatment of thromboembolism 
      in patients with HIT. Its elimination half-life is approximately 40-50 minutes, 
      and it is primarily eliminated by hepatic metabolism and biliary secretion. 
      Compared with historical controls, argatroban-treated patients with HIT or HIT 
      with thrombosis (HITTS) experienced lower rates of the composite end point of 
      death, amputation, and new thrombosis. Dosing is initiated at 2 microg/kg/min and 
      adjusted to maintain the activated partial thromboplastin time at 1.5-3 times the 
      patient's baseline. In Japan, argatroban is approved for use in acute ischemic 
      stroke and chronic peripheral occlusive disease. It has also been used as an 
      alternative to unfractionated heparin (UFH) in patients with a history of HIT or 
      HITTS undergoing percutaneous coronary intervention and other procedures. 
      Additionally, argatroban has been compared with UFH in patients with acute 
      myocardial infarction who were receiving thrombolytic therapy. Hemorrhage is the 
      primary adverse event associated with argatroban. Argatroban increases the 
      prothrombin time, making assessment of the intensity of warfarin therapy during 
      concurrent administration more complex. CONCLUSIONS: The use of argatroban in 
      patients with HIT and HITTS is associated with improvement in clinical outcomes 
      compared with historical controls. Argatroban offers several practical advantages 
      over other available agents with respect to dosing, monitoring, reversibility of 
      effect with discontinuation of the drug, and cost.
FAU - Kondo, L M
AU  - Kondo LM
AD  - School of Pharmacy, University of Washington, Seattle, USA.
FAU - Wittkowsky, A K
AU  - Wittkowsky AK
FAU - Wiggins, B S
AU  - Wiggins BS
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 0 (Pipecolic Acids)
RN  - 0 (Sulfonamides)
RN  - 9005-49-6 (Heparin)
RN  - 94ZLA3W45F (Arginine)
RN  - IY90U61Z3S (argatroban)
SB  - IM
MH  - Animals
MH  - Anticoagulants/*adverse effects
MH  - Antithrombins/adverse effects/pharmacokinetics/pharmacology/*therapeutic use
MH  - Arginine/analogs & derivatives
MH  - Clinical Trials as Topic
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Pipecolic Acids/adverse effects/pharmacokinetics/pharmacology/*therapeutic use
MH  - Sulfonamides
MH  - Thrombocytopenia/*chemically induced/*drug therapy
MH  - Thromboembolism/*drug therapy
RF  - 39
EDAT- 2001/04/17 10:00
MHDA- 2001/08/03 10:01
CRDT- 2001/04/17 10:00
PHST- 2001/04/17 10:00 [pubmed]
PHST- 2001/08/03 10:01 [medline]
PHST- 2001/04/17 10:00 [entrez]
AID - 10.1345/aph.10301 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2001 Apr;35(4):440-51. doi: 10.1345/aph.10301.