more on hit

[ollaguna]

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Let say it's someone who doesn't need long term anticoagulation; the patient was given heparin for DVT prophylaxis after surgery, developed thrombocytopenia, and soon develops a cold hand or something; Heprin is DC'd; Accoring to Marino you start coumadin and Dextran-40 (the argatroban website says nothing about coumadin); So I anticoag the pt to 1.5 - 2; How do I know when to DC the argatroban or coumadin? Patient doesn't stay on it indefinetly do they?

 

[Winged Scapula]

Oral anticoagulation for 3 months in the situation you describe, depending on the site and extent of DVT. If they embolize while on therapeutic treatment, then assess them for an IVC filter.

 

[droliver]

There are other commercial agents you'd give when you had to hold the heparin during the acute phase rather then Dextran in 2003. I only saw a scenario you described once or twice during my residency, I think one of them is Hirudin(?) which is made from a protein that leaches secrete I think

 

[maxheadroom]

You do use a hirudin-based anti-coagulant for HIT patients. I forget the name . . .

Come on, Ollie, as a new plastico you should be the leech master!!