Treatment of heparin-induced thrombocytopenia: a practical argatroban dosing protocol for nurses

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy that frequently leads to thrombosis. In patients with HIT, heparin should be discontinued immediately, and rapid-acting, alternative anticoagulation should be initiated. Argatroban is a parenteral direct thrombin inhibitor approved for prophylaxis or treatment of thrombosis in HIT. In this article, the recognition and treatment of HIT is discussed, and a practical dosing protocol for argatroban therapy that has been developed and used successfully by the nurses and physicians at Holy Cross Hospital in Ft. Lauderdale, Florida, is presented.