Document Detail


Clinical pharmacology of bivalirudin.
MedLine Citation:
PMID:  12064567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Much progress has been made in understanding and treating acute coronary syndromes. For patients undergoing percutaneous transluminal coronary angioplasty, anticoagulant therapy during the procedure must strike a balance between providing sufficient anticoagulation to prevent thrombus formation and ischemic complications while averting hemorrhagic complications. Bivalirudin, a thrombin-specific anticoagulant, is the only anticoagulant that reduces both ischemic and bleeding complications associated with percutaneous coronary intervention (PCI). Bivalirudin is easy to use, provides predictable anticoagulation, inactivates both free and clot-bound thrombin, and blocks thrombin-mediated platelet activation and aggregation. Drug-drug interaction studies have found no clinically relevant interactions between bivalirudin and ticlopidine, abciximab, tirofiban, or eptifibatide. Bivalirudin is well tolerated by patients who previously received low-molecular-weight heparin (LMWH), when LMWH is discontinued 8-14 hours before bivalirudin is started. Similarly, switching from heparin to bivalirudin at the time of PCI reduces both ischemic and bleeding events.
Authors:
Michael D Reed; Dawn Bell
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  22     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-14     Completed Date:  2003-01-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105S-111S     Citation Subset:  IM    
Affiliation:
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. mdr2@po.cwru.edu
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / therapy
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects
Anticoagulants / pharmacokinetics,  pharmacology*,  therapeutic use
Antithrombins / pharmacokinetics,  pharmacology*,  therapeutic use
Clinical Trials as Topic
Coronary Thrombosis / prevention & control
Drug Interactions
Fibrinolytic Agents / adverse effects,  pharmacology
Heparin / adverse effects,  pharmacology
Hirudins / analogs & derivatives*,  pharmacokinetics,  pharmacology*
Humans
Peptide Fragments / pharmacokinetics,  pharmacology*,  therapeutic use
Platelet Aggregation Inhibitors / pharmacology
Recombinant Proteins / pharmacokinetics,  pharmacology*,  therapeutic use
Thrombocytopenia / chemically induced
Ticlopidine / pharmacology
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antithrombins; 0/Fibrinolytic Agents; 0/Hirudins; 0/Peptide Fragments; 0/Platelet Aggregation Inhibitors; 0/Recombinant Proteins; 128270-60-0/bivalirudin; 55142-85-3/Ticlopidine; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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