ARGATROBAN Facts Sheet
Directions for Completing Educational Requirements for Argatroban Administration
This education material is MANDATORY for all RNs who may care for patients receiving Argatroban.
The purpose of the education is to review safe administration of Argatroban and to introduce the standard physician order sheet and administration record for Argatroban.
• The entire program takes approximately 15 minutes to complete.
• Read the pages that follow:
o Argatroban Fact Sheet
o Argatroban Orders
o Argatroban Administration Record
• Complete the posttest.
• The posttest will be automatically submitted electronically.
• A posttest score of 100% is required before caring for patients receiving Argatroban.
Contacts:
Peter Deringer, RN, MA Nursing, NE-BC - Nursing Professional Practice Coordinator
Phone: 484 526-6123 or peter.deringer@
Entity Pharmacists
ARGATROBAN Fact Sheet
Description & Use
Argatroban is an intravenous anticoagulant – specifically a synthetic direct thrombin inhibitor – that is used to treat patients with heparin-induced thrombocytopenia (HIT) or to anticoagulate patients who have a history of HIT.
Pharmacokinetics
Onset: Within 30 minutes
Peak: 1-2 hours; longer with moderate-severe hepatic impairment
Duration: ~1 hour after discontinuation; ~3 hours with moderate-severe hepatic impairment
Administration
Continuous intravenous infusion; 250 mg in 250 mL 0.9% sodium chloride; final concentration 1 mg/mL. Argatroban is included in the pump’s drug library, (Dose Mode).
Initial Dosing
▪ Initial dosing should NOT exceed 2 mcg/kg/min
▪ Use actual weight to dose up to 130 kg (use 130 kg for patients above 130 kg)
2 mcg/kg/min (STANDARD DOSING) for med/surg patients without hepatic impairment
1 mcg/kg/min (REDUCED DOSING) for med/surg patients without hepatic impairment, but with multi-organ dysfunction (e.g. heart failure, anasarca, renal failure)
0.5 mcg/kg/min (HEPATIC DOSING) for med/surg patients with moderate-severe hepatic impairment (AST or ALT greater than 2 times the upper limit of normal)
0.2 mcg/kg/min (CRITICAL CARE DOSING) for patients in critical care units
Monitoring
Baseline: CBC, aPTT, PT/INR, LFT (AST/ALT)
During Therapy: CBC daily, aPTT as indicated below
Adjustment
▪ Check aPTT 2 hours after initiating drip
▪ Check aPTT 4 hours after dose change
▪ If aPTT within therapeutic range for two sequential readings, check aPTT every 12 hours
▪ aPTT therapeutic range: 60 – 90 seconds
▪ For aPTT below 60 seconds, increase dose as ordered
▪ For aPTT above 90 seconds, decrease dose as ordered, hold infusion if indicated
Notify physician for aPTT above 121 seconds or for signs/symptoms of bleed
Notes
▪ When starting Argatroban, the physician should discontinue IV/SQ heparin, low-molecular-weight heparin (e.g. Lovenox®), and fondaparinux (Arixtra®) products, including flushes and coated catheters.
▪ Typically patients on Argatroban will transition to Warfarin (Coumadin) therapy. Because Argatroban inflates the INR, close communication between the nurse and physician is necessary during this transition period.
▪ The Argatroban Administration Record will be used to record Argatroban therapy (similar to Heparin and the Anticoagulation Administration Record). It is a permanent part of the chart.
If you would like additional information about Heparin Induced Thrombocytopenia (HIT), there is an option nursing CE program available on Tracker Trainer.
Please note:
Copies of the Argatroban Orders and Argatroban Administration Record follow on pages 4 & 5. Please be patient, it may take 15 seconds for the documents to load for viewing.
After reviewing the documents, exit out of this portion of the program and complete the posttest “Take Test”.
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