Molecular structure of argatroban, a direct thrombin inhibitor used as an alternative to<unk>  in<unk>  Given the fact that<unk>  predisposes strongly to new episodes of thrombosis, simply discontinuing the<unk>  administration is insufficient. Generally, an alternative anticoagulant is needed to suppress the thrombotic tendency while the generation of antibodies stops and the platelet count recovers. To make matters more complicated, the other most commonly used anticoagulant, warfarin, should not be used in<unk>  until the platelet count is at least 150 x 109/L because a very high risk of warfarin necrosis exists in people with<unk>  who have low platelet counts. Warfarin necrosis is the development of skin gangrene in those receiving warfarin or a similar vitamin K inhibitor. If the patient was receiving warfarin at the time when<unk>  is diagnosed, the activity of warfarin is reversed with vitamin K. Transfusing platelets is discouraged, as a theoretical risk indicates that this may worsen the risk of thrombosis; the platelet count is rarely low enough to be the principal cause of significant hemorrhage. Various nonheparin agents are used as alternatives to<unk>  therapy to provide anticoagulation in those with strongly suspected or proven<unk> : danaparoid, fondaparinux, bivalirudin, and argatroban. Not all agents are available in all countries, and not all are approved for this specific use. For instance, argatroban is only recently licensed in the United Kingdom, and danaparoid is not available in the United States. Fondaparinux, a factor Xa inhibitor, is commonly used off label for<unk>  treatment in the United States. According to a systematic review, people with<unk>  treated with lepirudin showed a relative risk reduction of clinical outcome (death, amputation, etc.) to be 0.52 and 0.42 when compared to patient controls. In addition, people treated with argatroban for<unk>  showed a relative risk reduction of the above clinical outcomes to be 0.20 and 0.18. Lepirudin production stopped on May 31, 2012.
Heparin-induced thrombocytopenia
Sticky platelet syndrome
Venom-induced consumption coagulopathy
Pseudo gray platelet syndrome
Drug-induced thrombocytopenic purpura
Gray platelet syndrome
Disseminated intravascular coagulation
Immune thrombocytopenic purpura