HIT
DOACs are options for treating HIT
As a hospital pharmacist, you will get questions about using direct oral anticoagulants (DOACs) for heparin-induced thrombocytopenia (HIT) . We usually treat HIT with IV argatroban or sometimes IV bivalirudin or subcutaneous fondaparinux ( Arixtra ). Then we transition to warfarin ( Marevan ) once the platelet count recovers, usually 150,000/mm3 or higher. Now there&…
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Thromboembolism
Thrombotic thrombocytopenia after Janssen or AstraZeneca vaccines
Patients will ask whether COVID-19 vaccines increase clot risk. This is due to reports of serious blood clots along with low platelets after the Johnson & Johnson/Janssen vaccine in the U.S and the AstraZeneca vaccine in other countries. Both are viral vector vaccines. Now the Janssen vaccine emergency use authorization (EUA) fact sheets will warn about this …
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Obesity
How to dose low-molecular-weight heparin (Clexane, etc) in very obese patients
There's still controversy about how to dose low-molecular-weight heparin (Clexane, etc) in very obese patients. Some physicians worry that doses based on total body weight will be too high for patients over 150 kg. This leads them to cap the dose to try to prevent overdosing. In fact, dalteparin labeling recommends a maximum treatment dose, the other low-molecula…
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Thromboembolism
Weigh venous thromboembolism (VTE) prevention strategies in COVID-19
Clinicians are scrambling to optimize venous thromboembolism (VTE) prophylaxis for hospitalized patients with COVID-19. Data suggest these patients have a higher VTE risk than other hospitalized patients. Plus D-dimer and other markers are often elevated in COVID-19 especially in severe cases. But there’s little evidence about optimal VTE prophylaxis in patients wi…
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HIT
Heparin-induced thrombocytopenia (HIT)
DESCRIPTION ㅡ There are two types of heparin-induced thrombocytopenia (HIT)... Type 1: Isolated HIT develops early in heparin therapy and is benign. No resultant bleeding or thrombotic complications. HIT type 1 NOT mediated by the immune system (passive heparin binding to platelets resulting in a modest shortening of the platelet life span). The platelet count rarel…
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