Activates antithrombin but due to shorter length preferentially inhibits factor Xa

is via direct irreversible binding to thrombin Causes a prolongation of bleeding time

up to 90% via SC (greater than heparin)

administered SC

less prot bind than heparin

Vd ~ 0.1L/kg

Hepatic depolymerisation and desulfation to less active fragments

urine as 40% of dose and 10% active fragments, dose adjustment in renal failure

excreted in the urine, dose adjustment
required in renal failure

2-4 times longer half-life than heparin
dose independent half time

Bleeding
Needs adjustment in renal failure
Less HITS and osteoporosis

Bleeding

Anticoagulants

Anticoagulants

1. the prevention of venous thromboembolic disease
2. the treatment of acute coronary syndromes.

Enoxaparin is a LMWH prepared from
unfractionated heparin by controlled
enzymatic or chemical depolymerisation
Consists of smaller fragments of
Heparin. MW: Average of 5000 Daltons

Is a naturally occurring peptide found in leaches saliva with anticoagulant properties
recombinant techniques are used to create drugs in this class

Level 1

Not in list
(Historical question)

Usually s/c, but can be given i.v.
20mg or 40mg BD s/c as prophylaxis, 1mg/kg BD s/c as therapeutic dose

Monitor:
Anti-Xa level

Reversal:
Protamine by slow infusion
Less e¬ffective than heparin due to the preferential Xa action (1mg/1mg
LMWH), but max effect is < 60%

Reversal:
irreversible binding - no reversal agent
dialysis with PMMA membranes works