Which of the following drugs is recommended for the treatment of heparin induced thrombocytopenia -

Ans. is 'b' i.e., Lepirudin Heparin induced thrombocytopenia (HIT) o Heparin induced thrombocytopenia is an impoant adverse effect of heparin administration, usually caused by unfractionated heparin, but may also be seen with the use of low molecular weight heparin (LMWH). o HIT may be of two types : Type 1 (Non-immune mediated) :- It is mild and heparin may be continued. Type 2 (Immune mediated) :- It is due to formation of antibodies against platelets. Paradoxical thrombosis can occur. Heparin must be discontinued immediately. Warfarin and LMW are contraindicated. Lepirudin (a direct thrombin inhibitor) is anticoagulant of choice. Alternatives are danaparoid, hirudin and Argatroban.