American Society of Hirudotherapy

Antithrombotic and Antiplatelet Drug Toxicity

Review published in Critical care clinics (2021)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsLiss DB et al. · Critical care clinics, 2021

Abstract

Anticoagulant and antiplatelet drugs target a specific portion of the coagulation cascade or the platelet activation and aggregation pathway. The primary toxicity associated with these agents is hemorrhage. Understanding the pharmacology of these drugs allows the treating clinician to choose the correct antidotal therapy. Reversal agents exist for some of these drugs; however, not all have proven patient-centered outcomes. The anticoagulants covered in this review are vitamin K antagonists, heparins, fondaparinux, hirudin derivatives, argatroban, oral factor Xa antagonists, and dabigatran. The antiplatelet agents reviewed are aspirin, adenosine diphosphate antagonists, dipyridamole, and glycoprotein IIb/IIIa antagonists. Additional notable toxicities are also reviewed.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsBlood CoagulationFibrinolytic AgentsHemorrhageHumansPlatelet Aggregation Inhibitors

Summary

Anticoagulant and antiplatelet drugs target a specific portion of the coagulation cascade or the platelet activation and aggregation pathway.

Why This Matters for Hirudotherapy

This review covers the pharmacology and toxicity—primarily hemorrhage—of anticoagulant and antiplatelet drugs, listing hirudin derivatives among the anticoagulants discussed alongside vitamin K antagonists, heparins, fondaparinux, argatroban, oral factor Xa antagonists, and dabigatran. It also addresses reversal agents and notes that not all have proven patient-centered outcomes. The inclusion of hirudin derivatives places this within ASH's domain of hirudin-related compounds. However, the abstract provides no specific data, findings, or conclusions about hirudin derivatives; they appear only as one drug class in a broad toxicology overview, with no original research, no hirudotherapy content, and no mention of leeches.

Citation

Antithrombotic and Antiplatelet Drug Toxicity

Liss DB et al. · Critical care clinics, 2021

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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