Direct Thrombin Inhibitors

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The page below is a sample from the LabCE course Antiplatelet and Anticoagulant Pharmacology for the Laboratory Professional. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Direct Thrombin Inhibitors

  • Examples: This class includes drugs such as dabigatran.
  • Mechanism of action: These drugs directly bind to and inhibit factor IIa (thrombin), resulting in a stoppage of the coagulation cascade.
  • Use: These drugs are primarily used for patients with HIT who need a drug similar to the rapid onset of heparin.
  • Laboratory measurement: aPTT, as with heparin.
  • Toxicity: Excessive bleeding is possible. There is now a reversal agent for this class of drugs- idarucizumab. Idarucizumab is an antibody that binds to and neutralizes the drugs of this class.