Pharmacokinetics of Subcutaneous Low Molecular Weight Heparin (Enoxaparin) in Dogs

2009 ◽  
Vol 45 (6) ◽  
pp. 261-267 ◽  
Author(s):  
Kari V. Lunsford ◽  
Andrew J. Mackin ◽  
V. Cory Langston ◽  
Marjory Brooks
Keyword(s):  
Molecular Weight ◽  
Veterinary Medicine ◽  
Low Molecular Weight Heparin ◽  
Patient Monitoring ◽  
Target Range ◽  
Low Molecular Weight ◽  
Close Monitoring ◽  
Low Molecular Weight Heparins ◽  
Pharmacodynamic Profile ◽  
Hemorrhagic Complications

Unfractionated heparin has been the standard heparin used in human and veterinary medicine for its anticoagulation effect; however, it has a complex pharmacodynamic profile that requires close monitoring. Low molecular weight heparins have a more predictable bioavailability, allowing standardized dosing without individual patient monitoring. This project was designed to a) evaluate the pharmacokinetics of the subcutaneous (SC) administration of the low molecular weight heparin, enoxaparin, in dogs using anti-Xa activity as a marker of plasma enoxaparin concentrations and b) to establish the dose necessary to maintain activity within an established target range. Enoxaparin at 0.8 mg/kg SC q 6 hours consistently maintained target levels of anti-Xa activity in normal dogs without evidence of hemorrhagic complications.

scholarly journals The anti-factor Xa range for low molecular weight heparin thromboprophylaxis

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Matthew Y. Wei ◽  
Salena M. Ward
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Dose Adjustment ◽  
Factor Xa ◽  
Research Data ◽  
Target Range ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Therapeutic Doses ◽  
Venous Thromboses

Low molecular weight heparins (LMWHs) are now the mainstay option in the prevention and treatment of venous thromboembolism. In some patients receiving therapeutic doses of LMWH, activity can be measured by quantifying the presence of Anti-factor Xa (AFXa) for dose adjustment. However, currently there are no guidelines for LMWH monitoring in patients on thromboprophylactic, doses, despite certain patient populations may be at risk of suboptimal dosing. This review found that while the AFXa ranges for therapeutic levels of LMWHs are relatively well defined in the literature, prophylactic ranges are much less clear, thus making it difficult to interpret current research data. From the studies published to date, we concluded that a reasonable AFXa target range for LMWH deep venous thromboses prophylaxis might be 0.2-0.5 IU/mL.

scholarly journals Modern low-molecular-weight heparins in the prevention and treatment of venous thromboembolic complications in oncourologic patients

2018 ◽  
pp. 106-112
Author(s):  
N. V. Vorobyev ◽  
S. V. Popov
Keyword(s):  
Molecular Weight ◽  
Impaired Renal Function ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Antithrombotic Effect ◽  
Low Molecular Weight Heparins ◽  
Prevention And Treatment ◽  
Venous Thromboembolic

Oncourologic diseases are accompanied by a risk for subsequent venous thromboembolic complications, which are rated the most dangerous in terms of thrombogenic effect. The article presents a review of the clinical studies of efficacy and safety, and the experience in using of modern low-molecular-weight heparins in clinical practice - drugs of choice for the prevention of venous thromboembolic complications in cancer patients. Particular attention is paid to Bemiparin - a new second-generation low-molecular-weight heparin with a significant antithrombotic effect and improved pharmacological parameters that allow it to be successfully used in patients with impaired renal function in oncourological practice.

Heparin and low-molecular-weight heparin

2008 ◽  
Vol 99 (11) ◽  
pp. 807-818 ◽  
Author(s):  
Barbara Mulloy ◽  
Trevor Barrowcliffe ◽  
Elaine Gray
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Clinical Status ◽  
Mechanisms Of Action ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Prevention And Treatment

SummaryHeparin is one of the oldest biological medicines, and has an established place in the prevention and treatment of venous thrombosis. Low-molecular-weight heparins (LMWH) have been developed by several manufacturers and have advantages in terms of pharmacokinetics and convenience of administration. They have been shown to be at least as effective and safe as unfractionated heparin and have replaced the latter in many indications. In this article the chemistry, mechanisms of action, measurement of anticoagulant activities, and clinical status of heparin and LMWH are reviewed.

scholarly journals Low Molecular Weight Heparin Induced Skin Necrosis without Platelet Fall Revealing Immunoallergic Heparin Induced Thrombocytopenia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Thomas Godet ◽  
Sébastien Perbet ◽  
Aurélien Lebreton ◽  
Guillaume Gayraud ◽  
Sophie Cayot ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Adverse Event ◽  
Differential Diagnosis ◽  
Renal Replacement Therapy ◽  
Skin Necrosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Functional Tests ◽  
Low Molecular Weight Heparins ◽  
Heparin Induced Thrombocytopenia

Low molecular weight heparins (LMWH) are commonly used in the ICU setting for thromboprophylaxis as well as curative decoagulation as required during renal replacement therapy (RRT). A rare adverse event revealing immunoallergic LMWH induced thrombopenia (HIT) is skin necrosis at injection sites. We report the case of a patient presenting with skin necrosis witnessing an HIT after RRT, without thrombocytopenia. The mechanism remains unclear. Anti-PF4/heparin antibodies, functional tests (HIPA and/or SRA), and skin biopsy are of great help to evaluate differential diagnosis with a low pretest probability 4T’s score.

scholarly journals Nursing Skill and Responsibility in Administration of Low Molecular Weight Heparin by Prefilled Syringe

2021 ◽  
pp. 85-92
Author(s):  
Vaishali Tembhare ◽  
Gaurav Mujbaile ◽  
Seema Singh ◽  
Achita Sawarkar ◽  
Maduri Shambharkar ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Blood Test ◽  
Low Molecular Weight Heparin ◽  
Occult Blood ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Protamine Sulphate ◽  
Subcutaneous Tissues ◽  
Skin Discoloration ◽  
Medicine Administration

Abstract: Low-molecular-weight heparins (LMWHs) have proven to be effective in the prevention and treatment of thrombotic disorders, as well as   substitute for unfractionated heparin (UFH). LMWHs are a diverse collection of medicines with different biochemical and pharmacological characteristics, despite the fact that they all have antithrombotic actions. Medicine is administered into the subcutaneous tissues with these injections. Small amounts of injections are delivered by the subcutaneous approach, which involves inserting a small thin needle beneath the skin and slowly injecting the medicine. Low molecular weight heparins make up dalteparin and enoxaparin, two anticoagulants. The rights of medicine administration must be followed by nurses. For patients on LMWH medication, the most essential blood test is prothrombin time. Following administration, look for any signs of bleeding, such as occult blood in the stool, malena, bleeding gums, and skin discoloration/hematoma. The antidote for low molecular weight heparin is protamine sulphate. It is effective at counteracting the effects of LMWH. 100 units of LMWH are neutralised by 1 mg of protamine sulphate.If it's been more than 8 hours since you've given LMWH, provide 0.5 mg protamin per 100 units of LMWH.

scholarly journals The use of low molecular weight heparins in patients with acute ST-elevated myocardial infarction

2006 ◽  
Vol 59 (9-10) ◽  
pp. 476-481 ◽  
Author(s):  
Milovan Petrovic ◽  
Gordana Panic ◽  
Tibor Canji ◽  
Ilija Srdanovic ◽  
Vladimir Ivanovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Molecular Weight ◽  
Unfractionated Heparin ◽  
Anticoagulant Therapy ◽  
Fibrinolytic Therapy ◽  
Low Molecular Weight ◽  
Cardiac Events ◽  
Low Molecular Weight Heparins ◽  
Adverse Cardiac Events ◽  
Hemorrhagic Complications

Introduction. According to the published guidelines for the management of acute coronary syndromes (ACS), treatment of acute ST-elevated myocardial infarction is based on rapid revascularization, either mechanical or pharmacological. Pharmacological revascularization consists of fibrinolytic therapy with antiplatelet and anticoagulant therapy. In regard to the anticoagulant therapy, low molecular weight heparins (LMWHs) are of special importance. LMWHs cause less complications (bleeding, thrombocytopenia, better bioviability) in comparison with unfractionated heparin (UFH). Some studies on use of LMWHs in ACS, show that LMWHs are equally efficient and safe as UFH, causing less complications (different types of hemorrhagic complications) (ESSENCE, TIMI 11B (enoxaparin), FRAXIS - fraxiparin), whereas some studies show better efficacy and safety of enoxaparin in therapy of acute ST-elevated myocardial infarction (ASSENT 3, ASSENT 3 PLUS, HART II, AMI-SK). Material and methods. Inclusion criteria: acute anterior myocardial infarction with ST-elevation, first myocardial infarction, no other structural heart defects, no signs of cardiogenic shock. Our study included 30 patients receiving fibrinolytic therapy with streptokinase, antiplatelet therapy and LMWH during 6 days, and 30 patients receiving UFH instead of LMWH. The follow-up period lasted for 6 months. Results. Significantly more patients receiving unfractionated heparin presented with major adverse cardiac events (73.3%) in regard to patients in the study group (44,2% nadroparin, 39.8% enoxaparin) (p=0.025). In the group receiving UFH, 6.7% patients had hemorrhagic complications, while none of patients receiving LMWHs. An equal number of patients died. Conclusion. Patients who were treated with LMWHs experienced less major adverse cardiac events and lower mortality. None suffered from hemorrhagic complications. .

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