USMLE

Dabigatran / Argatroban

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Hematology Drugs
  1. Dabigatran / Argatroban
  2. Factor Xa Inhibitors (Rivaroxaban, Apixaban)
  3. Heparin
  4. Low Molecular Weight Heparins (Enoxaparin, Fondaparinux, Dalteparin)
  5. Warfarin
  6. Aspirin
  7. GPIIb/IIIa Inhibitors (Abciximab, Tirofiban, Eptifibatide)
  8. Alteplase / tPA
  9. Iron
  10. Filgrastim
  11. Epoetin Alfa

Summary

Dabigatran and argatroban are drugs that belong to a class known as the direct thrombin inhibitors. These drugs are blood thinners or anticoagulants used to prevent the formation of blood clots. They are prescribed to people at an increased risk of blood clots, like those with a history of stroke, heart attack, DVT, pulmonary embolism, or atrial fibrillation. Since they prevent blood from clotting, dabigatran and argatroban have the side effect of causing severe bleeding. Finally, these medications should be kept in their original packaging to prevent moisture contamination.

Key Points

  • Mechanism
    • Direct thrombin inhibitors
      • Inhibit thrombin from converting fibrinogen to fibrin
    • Dabigatran is given orally, argatroban and bivalirudin are given intravenously
      • Dabigatran capsules should be kept in their original packaging to prevent moisture contamination.
    • Clinical Use
      • Prevention of blood clots
        • Prevention of stroke, myocardial infarction (MI), pulmonary embolism (PE), etc.
        • Prevention of clot formation related to atrial fibrillation
          • Contraindicated in patients with mechanical prosthetic valves due to increased risk of bleeding.
    • Side Effects and Adverse Reactions
      • Bleeding
        • Watch for signs of bleeding - tarry stools, ecchymosis, petechiae, bleeding gums
        • Implement bleeding precautions such as using a soft-bristled toothbrush and shaving with an electric razor