Gajra Ajeet, Husain Juhi, Smith Adrienne
SUNY Upstate Medical University, Department of Medicine, 750 E Adams Street, CWB # 275, Syracuse, NY 13210, USA.
Expert Opin Drug Metab Toxicol. 2008 Aug;4(8):1131-41. doi: 10.1517/17425255.4.8.1131.
Lepirudin is a recombinant hirudin that exerts its anticoagulant effect by direct inhibition of thrombin. Lepirudin is indicated for anticoagulation in patients with heparin-induced thrombocytopenia (HIT) and associated thromboembolic disease to prevent further thromboembolic complications.
This review addresses various clinical uses of lepirudin including but not limited to FDA approved indication. The objective is to provide an updated overview of the clinical use and pharmacology of the agent. In addition, we address certain areas of controversy especially pertaining to dosing of lepirudin and its use in different clinical situations.
Literature was reviewed using appropriate search terms in Pubmed and Ovid medline databases.
RESULTS/CONCLUSION: Lepirudin continues to be a valuable anticoagulant in the management of HIT. Lepirudin has the highest recommendation in treatment of HIT based on evidence from clinical trials. Minor modifications in dosing over the standard label recommendations may simplify its use and enhance safety.
水蛭素是一种重组水蛭素，通过直接抑制凝血酶发挥抗凝作用。水蛭素适用于肝素诱导的血小板减少症（HIT）及相关血栓栓塞性疾病患者的抗凝治疗，以预防进一步的血栓栓塞并发症。
本综述探讨了水蛭素的各种临床用途，包括但不限于美国食品药品监督管理局（FDA）批准的适应证。目的是提供该药物临床应用和药理学的最新概述。此外，我们还讨论了某些存在争议的领域，特别是与水蛭素给药及其在不同临床情况下的使用有关的问题。
在PubMed和Ovid医学数据库中使用适当的检索词对文献进行综述。
结果/结论：在HIT的管理中，水蛭素仍然是一种有价值的抗凝剂。根据临床试验证据，水蛭素在HIT治疗中具有最高推荐等级。在标准标签推荐剂量基础上进行微小调整可能会简化其使用并提高安全性。
