Direct thrombin inhibitor

Direct thrombin inhibitors (DTIs) are a type of anticoagulant that function directly on thrombin to prevent blood clot formation. They are used in the treatment of thrombosis and in the prevention of stroke in patients with atrial fibrillation.

Mechanism of Action

Direct thrombin inhibitors work by directly binding to thrombin and inhibiting its activity. Thrombin is a key enzyme in the coagulation cascade, which is responsible for the conversion of fibrinogen to fibrin, a protein that forms the framework of blood clots. By inhibiting thrombin, DTIs prevent the formation of fibrin and thus, blood clots.

Types of Direct Thrombin Inhibitors

There are several types of direct thrombin inhibitors, including:

• Dabigatran: An oral anticoagulant that is often used as an alternative to warfarin.
• Argatroban: A parenteral anticoagulant used in patients with heparin-induced thrombocytopenia.
• Bivalirudin: Used in patients undergoing percutaneous coronary intervention.
• Lepirudin: Used in patients with heparin-induced thrombocytopenia and associated thromboembolic disease.

Side Effects

Like all anticoagulants, direct thrombin inhibitors can cause bleeding. Other side effects can include nausea, diarrhea, and abdominal pain. In rare cases, they can cause allergic reactions.

Contraindications

Direct thrombin inhibitors should not be used in patients with active bleeding or a high risk of bleeding. They should also be used with caution in patients with kidney disease or liver disease, as these conditions can affect the body's ability to metabolize and excrete the drug.

See Also

• Anticoagulant
• Thrombin
• Blood clot
• Thrombosis
• Stroke
• Atrial fibrillation