Heparin-Induced Thrombocytopenia (HIT) – Part 4
In patients who have tested serologically positive for HIT or who are suspected on clinical grounds of developing HIT, heparin should be stopped immediately and an alternate form of antithrombotic therapy started. It is important to note that all heparin products should be discontinued, including
enoxaparin (Lovenox), which is a low-molecular weight heparin.
There are several forms of alternate therapy available in HIT. Two direct thrombin inhibitors (DTIs) commonly used are argatroban and lepirudin. DTIs have an antiplatelet effect (and thus prevent clotting) by inhibiting thrombin and thus prevents fibrinogen from forming fibrin. They are considered to be as effective as heparin in prophylaxis and treatment but are not first line drugs due to their much higher cost than either unfractionated heparin or low molecular weight heparin.
Copyright 2006 Insidesurgery.com