Argatroban - Critical Care Medication

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[@23Jpro]

I work on a PCU floor and for the first time had this gtt and was freaked out but felt more comfortable after watching this video.

[@Stephannied1]

Thanks!

[@ICUAdvantage]

Thank you so much! ❤

[@devika_it_is]

Love your efforts and informative videos ❤️ I wanna be a Nurse practitioner one day ... So your channel is really playing vital role in increasing my knowledge . Thank you 🥊

[@ICUAdvantage]

Awesome! Great to hear and glad you enjoy the videos I put out and find them helpful. Wishing you all the best in your goals!

[@yDoUevenTry4]

as i study for CRNA school you are amazing.

[@dgmnhn2098]

Thanks a lot !

[@jigokunoarisu]

We use bivalirudin for HIT where I’m from, so it was interesting to learn about this argatroban med!

[@ICUAdvantage]

Always cool to see different ways of doing things!

[@ADGMoN3y]

My last pt was on this because they had an allergy to heparin.

[@jasminesmalls3254]

Thanks from Kentucky

[@ICUAdvantage]

Youre welcome from NC 😊

[@munaf.aibrahim1238]

Thanks 🙏 its very useful knowledge great regards ☺️

[@ICUAdvantage]

Most welcome 😊

[@sushmarai438]

50th like and 3rd cmnt Love from nepal😍😍 Thanks for this amazing video and explanation😇😍😍😍

[@ICUAdvantage]

Very cool. Your are very welcome and thanks for the love.

[@dhinalabraham2590]

Thanks

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Welcome

[@linrusong5042]

Thank you

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You're welcome

[@munganiayvonne3548]

Thanks mwalimu 🇰🇪🙏😍

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Youre welcome!

[@kiner30]

Can’t you give pt factor 2 to reverse the effect of agatroban since it inhibits thrombin? (Or is factor 2 currently nonexistent?). Also what property from the agatroban agent would induce the arrhythmic episode? If I recall correctly, my institution uses factor 10 to reverse some of the effects of this medication. As always thank you for your service and efforts in educating the community.

[@ivantarandovskiy4765]

Actually, the reversal agents for novel coagulation inhibitors are now of a big interest. People try using prothrombin complex concentrates. Also, for factor xa inhibitors there is fda approved andexanet which is actually inactive factor xa. Super expensive thing :-(

[@ICUAdvantage]

So there is no direct Factor II alone that I've seen, although theoretically it could and should be able to be separated (and maybe it is that I just haven't seen). It is a component in PCC as well as is in FFP. FFP was guided as the recommendation if needing to reverse. Usually the suggestion was that due to a pretty low plasma half-life, stopping the infusion was often good enough. As for giving Factor X, or any others further up the cascade, they all ultimately will lead to more thrombin conversion, which will make more available to potentially outweigh the effects of any bound thrombin. (Think giving platelets to patients with inactivated platelets due to P2Y12 inhibitors.) Interesting there is Praxbind which is given for Pradaxa which is also another direct thrombin inhibitor. This works though by binding directly with Pradaxa, so I wonder if something similar may come about but that specifically binds Argatroban. As Ivan mentioned I think in the future there will be more specific binding medications like these, especially as we begin using more and more AI for protein folding and molecular bonding exploration. Finally, as for the cardiac side effects, there isn't a ton of information on it, but I don't know if its necessarily something specific to an interacting/binding or it it could be immune mediated response in some way. That I don't really have a good answer for.

[@ivantarandovskiy4765]

Next video should be on DOACs and their possible reversal agents

[@ICUAdvantage]

Thanks for the suggestion

[@thedirtbagbougieknitteryar3216]

also don't panic if you see elevated INR after initiation as this drug can falsely elevate the INR.