Low-molecular-weight heparin in the prevention and treatment of thromboembolic disorders

1998 ◽  
Vol 1 (5) ◽  
pp. 166-174 ◽  
Author(s):  
Evelyn R Hermes De Santis ◽  
Betsy S Laumeister ◽  
Vidhu Bansal ◽  
Vandana Kataria ◽  
Preeti Loomba ◽  
...  
2018 ◽  
pp. 106-112
Author(s):  
N. V. Vorobyev ◽  
S. V. Popov

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.


2006 ◽  
Vol 89 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Sérgio Luiz Dalmora ◽  
Maximiliano da Silva Sangoi ◽  
Thiago Barth ◽  
Liberato Brum ◽  
Silvana Ferreira Vaccari

Abstract The low-molecular weight heparin nadroparin calcium is used clinically for the prevention and treatment of venous and arterial thrombosis. The antifactor Xa and antifactor IIa assays were validated by investigating the parameters of range, linearity (r2 0.9905 and r2 0.9914, respectively) precision, accuracy, and robustness. The 2 methods incorporated a chromogenic endpoint and detection at 405 nm, yielding good results with detection limits of 0.004 and 0.01 IU/mL and quantitation limits of 0.01 and 0.03 IU/mL, respectively, for the antifactor Xa and antifactor IIa assays. Nadroparin calcium pharmaceutical products were evaluated by the antifactor Xa assay and the antifactor IIa assay, giving potencies between 93.86 and 109.88%, with an antifactor Xa/antifactor IIa ratio between 3.2 and 3.7. The results demonstrated the validity of the assays that are useful methodologies for the routine quality control of nadroparin in pharmaceutical formulations.


2008 ◽  
Vol 99 (11) ◽  
pp. 807-818 ◽  
Author(s):  
Barbara Mulloy ◽  
Trevor Barrowcliffe ◽  
Elaine Gray

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.


2001 ◽  
Vol 85 (06) ◽  
pp. 947-949 ◽  
Author(s):  
Theodore Warkentin

SummaryFew topics in medicine rival heparin-induced thrombocytopenia (HIT) for the unexpected twists and turns enough to rival the plot of many a mystery novel. The underlying theme- anticoagulant-induced thrombosis- seems improbable, but is well-established: despite thrombocytopenia, patients rarely bleed spontaneously or even exhibit petechiae (1); rather, thrombosis develops in 30-75% of patients with HIT, depending upon the clinical situation, and in proportions far greater than expected based on the original reason for receiving heparin (2-4).But even beyond this fundamental contradiction, there exists for the unwary and uninformed practitioner several counterintuitive treatment paradoxes. One is the dichotomous nature of low-molecular-weight heparin (LMWH) respecting prevention and treatment of HIT. LMWH is far less likely to cause HIT than standard, unfractionated heparin (4, 5). Yet, for the patient with acute HIT caused by unfractionated heparin, LMWH is contraindicated (6, 7). The reason: LMWH preparations contain some heparin molecules with 12 or greater saccharide units, which are sufficiently long to bind platelet factor 4 (PF4), creating the multimolecular complexes bearing the HIT antigens. Consequently, ongoing platelet activation, thrombocytopenia, and thrombosis occur in many patients so treated (8).


2007 ◽  
Vol 97 (04) ◽  
pp. 505-513 ◽  
Author(s):  
André Kher ◽  
Jorn Nielsen ◽  
Rupert Bauersachs

SummaryFatal pulmonary embolism remains the most common cause of mortality among pregnant women in many Western countries. The physiological changes of pregnancy produce a hypercoagulable state that increases the risk of venous thromboembolism (VTE).Women with inherited or acquired thrombophilias are at particularly high risk of VTE during pregnancy, and thromboprophylaxis may be advisable in some cases. Thrombophilia is also associated with complications of pregnancy, including fetal loss, pre-eclampsia, intra-uterine growth restriction, and placental abruption. The antithrombotic agents available for the prevention and treatment of VTE during pregnancy, and pregnancy complications, include unfractionated heparin (UFH), low-molecular-weight heparin (LMWH) and aspirin. Vitamin K antagonists are contra-indicated in pregnancy. Low-dose aspirin may have a role in the prevention of some pregnancy complications, although its safety in early and late pregnancy is uncertain. The efficacy and safety of LMWHs have been demonstrated for the prevention and treatment of VTE in pregnancy. These agents are increasingly being used in place of UFH, which is associated with a higher incidence of side effects compared with LMWH, in addition to the need for regular laboratory monitoring. Evidence is also emerging to support the use of LMWH in the prevention of recurrent fetal loss, although further trials are needed to explore the role of LMWHs in this indication and in the prevention of other complications of pregnacy.


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