New antithrombotics for the intensive care unit setting: GP IIb/IIIa inhibitors, low-molecular-weight heparins, and direct thrombin inhibitors.
Thromboembolic disease (TED) is a frequent problem encountered by clinicians in the intensive care unit (ICU). Traditionally, unfractionated heparin (UFH) has been used in the treatment and prophylaxis of TED. However, newer antithrombotic agents have evolved as effective alternatives to UFH. Low-molecular-weight heparins are effective for both the treatment and prophylaxis of TED. Lepirudin is useful for patients with TED and a history of heparin-induced thrombocytopenia. The platelet glycoprotein IIb/IIIa inhibitors are synergistic with UFH for the treatment of acute coronary syndromes and percutaneous coronary interventions (PCI). Several drugs are now available to clinicians for the treatment and prophylaxis of TED.
DiDomenico
R J
RJ
Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 60612, USA. rdidom1@uic.edu
D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology; D005343:Fibrinolytic Agents / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D013917:Thrombin / Q000037:antagonists & inhibitors*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D013917:Thrombin