02-13-2008, 07:28 AM
some more concepts !!LMW HEPARIN VS heparin
Differences from unfractionated heparin
Its differences with unfractioned heparin include:
Average molecular weight: heparin is about 20000 Da and LMWH is about 3000 Da
Once-daily dosing, rather than a continuous infusion of unfractionated heparin
No need for monitoring of the APTT coagulation parameter
Possibly a smaller risk of bleeding
Smaller risk of osteoporosis in long-term use
Smaller risk of heparin-induced thrombocytopenia, a feared side-effect of heparin.
The anticoagulant effects of heparin are typically reversible with protamine sulfate, while the effect on LMWH is limited
[edit] Clinical uses
Because it can be given subcutaneously and does not require APTT monitoring, LMWH permits outpatient treatment of conditions such as deep vein thrombosis or pulmonary embolism that previously mandated inpatient hospitalization for unfractionated heparin administration
The use of LMWH needs to be monitored closely in patients at extremes of weight or in-patients with renal dysfunction. An anti-factor Xa activity may be useful for monitoring anticoagulation. Given its renal clearance, LMWH may not be feasible in patients that have end-stage renal disease.
[edit] Use in venothromboembolic disease associated with cancer
The CLOT study, published in 2003, showed that, in patients with malignancy and acute venous thromboembolism, dalteparin was more effective than coumarin in reducing the risk of recurrent embolic events
Low molecular weight heparin
ex;enoxaparin,dalteparin(I think so)
leupridin is direct thrombin inhibitor
Differences from unfractionated heparin
Its differences with unfractioned heparin include:
Average molecular weight: heparin is about 20000 Da and LMWH is about 3000 Da
Once-daily dosing, rather than a continuous infusion of unfractionated heparin
No need for monitoring of the APTT coagulation parameter
Possibly a smaller risk of bleeding
Smaller risk of osteoporosis in long-term use
Smaller risk of heparin-induced thrombocytopenia, a feared side-effect of heparin.
The anticoagulant effects of heparin are typically reversible with protamine sulfate, while the effect on LMWH is limited
[edit] Clinical uses
Because it can be given subcutaneously and does not require APTT monitoring, LMWH permits outpatient treatment of conditions such as deep vein thrombosis or pulmonary embolism that previously mandated inpatient hospitalization for unfractionated heparin administration
The use of LMWH needs to be monitored closely in patients at extremes of weight or in-patients with renal dysfunction. An anti-factor Xa activity may be useful for monitoring anticoagulation. Given its renal clearance, LMWH may not be feasible in patients that have end-stage renal disease.
[edit] Use in venothromboembolic disease associated with cancer
The CLOT study, published in 2003, showed that, in patients with malignancy and acute venous thromboembolism, dalteparin was more effective than coumarin in reducing the risk of recurrent embolic events
Low molecular weight heparin
ex;enoxaparin,dalteparin(I think so)
leupridin is direct thrombin inhibitor