False Neurotransmitter

Hematologic: Bleeding, hemorrhage, disseminated intravascular coagulation (DIC)

Derived from the leech ( Hirudo medicinalis), hirudin is a specific thrombin inhibitor; inhibits conversion of fibrinogen to fibrin

Absorption: S.C.: 36%

Distribution: V_d: 0.2 L/kg

Half-life:

I.V.: 0.6-1.6 hours

S.C.: 0.6-3 hours

Elimination: Renal

I.V.:

Infusion: 0.06-0.15 mg/kg/hour

Activated PTT, CBC

No consistent benefit when combined with standard anticoagulation therapy for the treatment of acute MI and unstable angina pectoris.

1 mcg of hirudin inhibits ~10 units of human thrombin; risk of bleeding increases with bolus >0.6 mg/kg and infusion >0.2 mg/kg

Antman EM, "Hirudin and Acute Myocardial Infarction. Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9B Trial," Circulation, 1996, 94(5):911-21.

Serruys PW, Herrman JP, Simon R, et al, "A Comparison of Hirudin With Heparin in the Prevention of Restenosis After Coronary Angioplasty. Helvetica Investigators," N Engl J Med, 1995, 333(12):757-63.

Topol EJ, Fuster V, Harrington RE, et al, "Recombinant Hirudin for Unstable Angina Pectoris. A Multicenter, Randomized Angiographic Trial," Circulation, 1994, 89(4):1557-66.