NAPLEX Practice Question # 93

NAPLEX Examination.

Practice Question # 93.


Naplex

 

Anticoagulant agents

Direct thrombin inhibitors

  1. These agents are able to inhibit thrombin activity by interacting with the catalytic or substrate recognition site of the protease without the need for AT-III.
  2. Lepirudin (Refl udan®) is a 65 amino acid recombinant derivative of hirudin, the anticoagulant found in the saliva of the medicinal leech. Bivalirudin (Angiomax®) is a synthetic 20 amino acid derivative of hirudin.
  3. These agents are administered parenterally to inhibit thrombin activity and reduce the formation of thrombi. Argatroban is also a parenterally administered, direct thrombin inhibitor, and all three of these agents are used to treat HIT. Bivalirudin is also used to prevent thrombosis after coronary angioplasty procedure. Dabigatran (Pradaxa®) is the fi rst orally active direct thrombin inhibitor and is used to prevent stroke in patients with atrial fi brillation.
  4. Adverse eff ects to these agents are usually bleeding, but dabigatran is also associated with GI disturbances such as esophageal refl ux, gastric bleeding, and abdominal pain.

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