What are examples of unfractionated heparin?

There are two types of heparin drugs comprising unfractionated heparin (UFH), also known as standard heparin, and low molecular weight heparin (LMWH). LMWH is constituted by a group of several drugs (for example, enoxaparin, dalteparin, nadroparin, tinzaparin, certoparin) (Hirsh 2004).

What is unfractionated heparin brand name?

Heparin, also known as standard heparin or unfractionated heparin (UFH), is a generic injection. Heparin also goes by brand names such as Hep-Lock.

Is fondaparinux unfractionated heparin?

Fondaparinux (Arixtra) is an anticoagulant that shares the same pentasaccharide sequence as UFH and LMWH for the binding to antithrombin, however it has no extra chain and thus, is not considered a heparin product. It is also known to not cause HIT, as seen with UFH and LMWH.

Is enoxaparin unfractionated heparin?

Two new anticoagulants (bivalirudin and enoxaparin) have proved to be superior to unfractionated heparin during percutaneous coronary intervention, particularly in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention.

What is the difference between LMWH and UFH?

LMWH has a greater effect on anti-Xa and less effect on thrombin (factor IIa) compared to UFH. This means that LMWH doesn’t strongly affect the PTT, and cannot be monitored by measuring the PTT level.

Is LMWH fractionated?

LMWHs are defined as heparin salts having an average molecular weight of less than 8000 Da and for which at least 60% of all chains have a molecular weight less than 8000 Da. These are obtained by various methods of fractionation or depolymerisation of polymeric heparin.

Is Coumadin unfractionated heparin?

Warfarin (Coumadin), unfractionated heparin, and low-molecular-weight heparins (LMWHs) are used for the treatment of venous thromboembolism (VTE), the prevention of systemic embolism associated with atrial fibrillation or the use of prosthetic heart valves, and the prevention of stroke and recurrent myocardial …

What is fractionated and unfractionated heparin?

LMWH is obtained by fractionation of polymeric heparin. LMWH differs from unfractionated heparin in a number of ways, including the average molecular weight; the need for only once or twice daily dosing; the absence of monitoring the aPTT; and the lower risk of bleeding, osteoporosis, and HIT.

Is dalteparin unfractionated heparin?

Dalteparin, a low molecular weight heparin (LMWH) prepared by nitrous acid degradation of unfractionated heparin of porcine intestinal mucosa origin, is an anticoagulant.

What type of anticoagulant is fondaparinux?

Fondaparinux (Arixtra) is a synthetic anticoagulant based on the pentasaccharide sequence that makes up the minimal antithrombin (AT) binding region of heparin. Similar to low molecular weight heparins, it is an indirect inhibitor of factor Xa, but it does not inhibit thrombin at all.

What is the difference between LMWH and unfractionated heparin?

What is the difference between fondaparinux and enoxaparin?

Fondaparinux is a factor Xa inhibitor and does not inhibit thrombin (IIa) [8]. Enoxaparin on the other hand, binds to antithrombin to form a complex molecule that can irreversibly inactivate clotting factor Xa and it has less activity against thrombin [9]. This is how these two anticoagulants work.

Is protamine sulphate an inhibitor of heparin?

Protamine sulphate is an effective inhibitor of heparin and is used clinically to neutralise both low molecular weight heparins (LMWH) and unfractionated heparin (UFH). However, protamine sulphate does not fully counter the anti-Xa effect of LMWH, even in excess (>40 μg to 1 IU/ml).

How is protamine dose calculated for patients on heparin infusions?

For patients on heparin infusions, due to the half-life of heparin, the amount of heparin administered over the previous 2 hours should be utilized to calculate a protamine dose. 3, 5

What are the alternatives to protamine for heparin reversal?

Protamine remains as the only FDA approved reversal agent for unfractionated heparin. Unfortunately, there are no alternatives readily available for use in the event of protamine shortage. Due to lack of protamine alternatives, substitutions for the heparin/protamine combination such as bivalirudin should be considered in appropriate procedures.

What is unfractionated heparin?

Unfractionated Heparin. Administration of full dose protamine is indicated in patients who need reversal less than 60 minutes after bolus administration. For patients on heparin infusions, due to the half-life of heparin, the amount of heparin administered over the previous 2 hours should be utilized to calculate a protamine dose. 3,5.