Patients requiring anticoagulation for HIT or with a history of HIT may be initiated on argatroban. We have recently been seeing increased utilization. Here are some important points to remember.
MOA: Direct thrombin inhibitor – reversibly binds to the active thrombin site of free and clot-associated thrombin
Monitoring parameters:
aPTT prior to starting therapy (similar to heparin)
aPTT two hours after initiation of therapy or after dose change
Signs/symptoms of bleeding, LFTs, CBC, Hgb/Hct
Dosing (general): 2 mcg/kg/min (actual body weight)
Important notes:
Discontinue all heparin products including hep locks and coated catheters. This includes all LMWH such as enoxaparin.
Causes false elevation of INR by cross-reacting with the INR assay
