Question:medium
Which of the following drugs is recommended for the treatment of heparin induced thrombocytopenia?
Which of the following drugs is recommended for the treatment of heparin induced thrombocytopenia?
Show Hint
Stop heparin and switch to a direct thrombin inhibitor.
Updated On: Jun 24, 2026
- Abciximab
- Lepirudin
- Warfarin
- Alteplase
Show Solution
The Correct Option is B
Solution and Explanation
In heparin induced thrombocytopenia the immune system attacks the heparin and platelet factor 4 complex, dropping platelets yet pushing the patient into dangerous clotting. The first move is to stop every form of heparin, then anticoagulate with a drug that has nothing to do with heparin.
Lepirudin fits this need. It is a lab-made version of hirudin that directly blocks thrombin and works independently of antithrombin or heparin, so it neither feeds the antibodies nor needs heparin to act. That is precisely why it is recommended in HIT.
The other agents miss the mark. Abciximab blocks the platelet GP IIb/IIIa receptor and is a tool for coronary intervention, not an anticoagulant for HIT. Warfarin is actually hazardous if started alone during acute HIT because it can trigger limb gangrene by knocking out protein C early; it is introduced only after platelets recover. Alteplase is a clot-buster for acute stroke or heart attack and does not address the underlying clotting tendency of HIT.
$\therefore$ Lepirudin, a direct thrombin inhibitor, is the recommended drug for HIT.
\[\boxed{\text{Lepirudin}}\]
Lepirudin fits this need. It is a lab-made version of hirudin that directly blocks thrombin and works independently of antithrombin or heparin, so it neither feeds the antibodies nor needs heparin to act. That is precisely why it is recommended in HIT.
The other agents miss the mark. Abciximab blocks the platelet GP IIb/IIIa receptor and is a tool for coronary intervention, not an anticoagulant for HIT. Warfarin is actually hazardous if started alone during acute HIT because it can trigger limb gangrene by knocking out protein C early; it is introduced only after platelets recover. Alteplase is a clot-buster for acute stroke or heart attack and does not address the underlying clotting tendency of HIT.
$\therefore$ Lepirudin, a direct thrombin inhibitor, is the recommended drug for HIT.
\[\boxed{\text{Lepirudin}}\]
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