Epistemis

Synthesis and Summary of Hematological Monitoring

To facilitate quick memorization and precision clinical decision-making, a general diagnostic monitoring map is presented for each pharmacological group analyzed.

File

Pharmacological GroupRepresentative DrugMain Monitoring ParameterSpecific Antidote / Reversal
Parenteral AnticoagulantsUnfractionated HeparinPaTT (target 1.5 - 2.5 times control) / Anti-XaProtamine Sulfate
Low Molecular Weight HeparinsEnoxaparin SodiumNon-systematic. Anti-Xa Activity in obese or pregnant womenProtamine Sulfate (partial reversal ~60%)
Vitamin K AntagonistsWarfarin / AcenocoumarolINR (target 2.0 - 3.0 / 2.5 - 3.5 in mechanical valves)Vitamin K1 (Phytomenadione) / Prothrombin Complex (4-F)
Thrombin Inhibitors (DOACs)Dabigatran EtexylateNon-systematic. Ecarina Time / Thrombin TimeIdarucizumab (*Praxbind*)
Factor Xa inhibitors (DOACs)Rivaroxaban / ApixabanNot systematic. Specific Calibrated Anti-Xa AssaysAndexanet Alfa (*Ondexxya*)
Thienopyridine AntiplateletsClopidogrelPlatelet function (VerifyNow) / Genotype CYP2C19Platelet transfusion (in case of imminent bleeding)
Synthetic AntifibrinolyticsTranexamic AcidCreatinine level and kidney function (strict dose adjustment)There is no specific antidote
Hematopoietic Growth FactorsFilgrastimAbsolute Neutrophil Count (ANC) / HemogramTemporary suspension / Symptomatic support

"Success in advanced hematological therapy consists of maintaining biological balance: enough power to avoid thrombosis, but the lowest dose to prevent bleeding."

Epistemis is educational review material. It is not a medical device, does not diagnose or prescribe treatment, and does not replace formal medical training, current clinical guidelines, or professional clinical judgment.

System
Hematology
Cluster
Integration and Advanced Review
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