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What is Which one the following drugs is a Parenteral Direct Thrombin Inhibitor ? and explain in detail?
INJECTABLE DIRECT THROMBIN INHIBITORS: HIRUDIN LEPIRUDIN BIVALURIDIN ARGATROBAN MELAGATRAN ORAL DIRECT THROMBIN INHIBITOR: DABIGATRAN Argatroban : A synthetic compound based on the structure of L-Arginine, binds reversibly to the active site of Thrombin . Its is administered Intravenously and has a T1/2 of 40-50 min. It is metabolized in the liver and excreted in the bile. In patients with renal impairment, but dose reduction is required for patients with hepatic insufficiency. Argatroban is licensed for the prophylaxis or treatment of patients with, or at risk of developing, Heparin-induced Thrombocytopenia . It prolongs both aPTT and PT, which can complicate the transitioning of patients from argatroban to warfarin. A factor X assay can be used instead of the PT to monitor warfarin in these patients.