Thrombin inhibitors, anticoagulant therapy

Finally, with the use of direct thrombin inhibitors such as hirudin for anticoagulant therapy, laboratory tests such as APTT may not be sensitive enough to follow therapy. 

F. Role in therapy The potential advantages of Angiomax—a direct thrombin inhibitor—over heparin include activity against clot-bound thrombin, more predictable anticoagulation, and no inhibition by components of the platelet release reaction. The place in therapy of Angiomax will be determined by further comparisons with heparin, low-molecular weight heparins, and recombinant hirudin. 

Andersen JC. Advances in anticoagulation therapy the role of selective inhibitors of factor Xa and thrombin in thromboprophylaxis after major orthopedic surgery. Semin Thromb Hemost. 2004 30 609-618. 

Hirudin is a potent thrombin inhibitor that is used as an anticoagulant. During production of the recombinant desulfatohirudin variant (r-Hr) for anticoagulation therapy in humans by recombinant technology, seven variants were observed as either by-products or degraded forms of r-Hr. All the major variants have been separated in an uncoated capillary with 60 mM acetate buffer (pH 4.4) containing 0.3% PEG 20,000 and 0.1 mM Zn2+.42... 

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