Hirudins

Background

• Direct thrombin inhibitors

Drugs

• Hirudin
• Lepirudin
• Argatroban

Indications

• HIT
• Unstable angina/NSTEMI/PCI

Complications

• Bleeding
  • Majority of bleeding events occur at invasive sites
  • No antidote available
  • Minor bleeding
    • Stop infusion
  • Major bleeding
    • Give FFP or PCC

Pharmacology

• Half-life is ~2hr