A REVIEW ON SAFETY AND EFFICACY OF DIRECT THROMBIN INHIBITORS
Direct thrombin inhibitors (DTIs) are a new class of anticoagulants used over other anticoagulants like GP IIa/IIb inhibitors, heparin, warfarin and low molecular weight heparins. The active molecule of direct thrombin inhibitors are derived from the salivary enzymes of a medicinal leech namely HIRUDO MEDICINALIS. DTIs have many clinical uses like prevention of coagulation in atrial fibrillation, orthopedic hip replacement surgery, unstable angina, coronary angioplasty, ST-segment elevated myocardial infarction, heparin-induced thrombocytopenia and venous thromboembolism etc., DTIs act by directly inhibiting both free and fibrin-bound thrombin. The present review describes all biochemistry, pharmacokinetic and pharmacodynamic data of various DTIs like bivalirudin, hirudin, lepirudin, argatroban, ximelagtran/melagatran, desirudin with their indications and side effects and comparative study results between the class of drugs and other class of anticoagulants like warfarin, heparin.