[Direct thrombin inhibitors: pharmacology and application in cardiovascular anesthesia].
The options for drug-controlled anticoagulation are becoming noticeably more manifold. In the area of anaesthesiology and intensive care, there are furthermore special disease patterns, such as heparin-induced thrombocytopenia (HIT) to be known, diagnosed and treated. This article gives a review of the substance groups of the direct thrombin inhibitors (DTI) as alternative anticoagulants for HIT in combination with cardiovascular diseases. For the administration of DTIs, experience and the correct dose are the keys to success and are the deciding factors for the two sides of haemostasis: thrombosis and haemorrhage.
Kozek-Langenecker
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SA
Abteilung für Spezielle Anästhesie und Schmerztherapie, Univ-Klinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Osterrreich. sibylle.kozek@meduniwien.ac.at
D000758:Anesthesia; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D013504:Cardiovascular Surgical Procedures; D003422:Critical Care; D006470:Hemorrhage / Q000517:prevention & control; D006487:Hemostasis / Q000187:drug effects; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006494:Heparin Antagonists / Q000627:therapeutic use; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013917:Thrombin / Q000037:antagonists & inhibitors*; D013927:Thrombosis / Q000097:blood / Q000139:chemically induced
D000925:Anticoagulants; D006494:Heparin Antagonists; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; D013917:Thrombin; C074619:bivalirudin; C060225:desirudin; C083544:lepirudin