Coagulation
Therapy related coagulopathies
Hirudin



Topic Completed: 1 June 2012

Revised: 4 January 2019, last major update June 2012

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PubMed Search: Hirudin [title]


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Cite this page: Parsons J. Hirudin. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/coagulationhirudin.html. Accessed October 19th, 2019.
Definition / general
  • Anticoagulant approved by FDA to treat thrombosis in patients with heparin induced thrombocytopenia (does not itself cause this type of syndrome)
  • Derivatives include lepirudin, refludan
  • Recombinant protein, cloned from a leech (Wikipedia), which directly inhibits factor IIa (thrombin)
  • Also has fibrinolytic properties
  • More predictable anticoagulant effect than standard heparin, less need for laboratory monitoring, although close monitoring is still advised with PTT, though this assay has limitations (ecarin clotting time is preferable)
  • Prolongs PT, PTT, thrombin time, ACT, and interferes with most clotting based assays
  • Therapeutic range to treat DVT is PTT that is 1.5 - 2.5 x normal, but more specific assays are also used to monitor, such as ecarin clotting time
  • Half-life ~one hour, may be prolonged if antibodies develop, dramatically prolonged in renal failure
  • No reversal agent
Additional references
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