prothrombin complex (Kcentra) is not an appropriate antidote for argatroban in HIT patients!
argatroban should generally not be interrupted during procedures unless there is a specific physician order.
High Alert Drug: direct thrombin inhibitors
• Nurses and pharmacists verify dose and that patient is not on heparin or other anticoagulant prior to administration. • Two RNs independently verify dose prior to administration if the dosing requires manipulation (i.e. drawing up a portion of a vial, or giving a portion of a syringe}. • Anticoagulation comparison chart available on nursing units for reference. • Pharmacists/nurses provide patient education for oral anticoagulants. • Pharmacists monitor labs for appropriate dosing and prevention of adverse events. • Reversal agents and order sets for oral anticoagulants
Per policy, these medications require cardiac and/or special monitoring. (KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
generic (Brand) / Notes
argatroban IV Infusion
Y
Y
Y
Y
Y
N
N
N
Per policy, these hazardous drugs have special waste requirements.
Generic (Brand)
Waste Requirements
argatroban
Hazardous Waste ⇒ BLACK BUCKET
Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand)
Dept.
Procedure Type (hover over entry for examples)
Stop Medication Prior To Procedure Restart after:
argatroban
Anesthesia
High-risk
No data Restart after No data
Intermediate-risk
No data Restart after No data
Low-risk
No data Restart after No data
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
Invasive Procedures
8 hours
Paracentesis/Thoracentesis
No hold
Surgery
High-risk
No data Restart after No data
Low-risk
No data Restart after No data
Last updated: Apr. 17, 2024
Hazardous Waste BLACK BUCKET
Look-Alike/Sound-Alike argatroban confused with Aggrastat, Orgaran
• Two RNs independently verify dose prior to administration if the dosing requires manipulation (i.e. drawing up a portion of a vial, or giving a portion of a syringe}.
• Anticoagulation comparison chart available on nursing units for reference.
• Pharmacists/nurses provide patient education for oral anticoagulants.
• Pharmacists monitor labs for appropriate dosing and prevention of adverse events.
• Reversal agents and order sets for oral anticoagulants
(KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
IV Infusion
(hover over entry for examples)